AdvancedUserGuide
bk3000 & bk5000 Ultrasound Systems
16-01487-01
November 2018
For Professional Users Only
LEGAL MANUFACTURER
BK Medical Aps
Mileparken 34
DK-2730 Herlev
Denmark
Tel.:+45 4452 8100/Fax:+45 4452 8199
www.bkmedical.com
Email: info@bkmedical.com
The serial number label on a BK Medical product contains information about the year of manufacture.
BK Medical Customer Satisfaction
Input from our customers helps us improve our products and services. Your opinions are important to
us. You are always welcome to contact us via your BK Medical representative or by contacting us
directly.
Scanner Software
•
NOT FAULT TOLERANT
INDEPENDENTLY DETERMINED HOW TO USE THE SOFTWARE IN THE DEVICE, AND MS HAS
RELIED UPON BK Medical TO CONDUCT SUFFICIENT TESTING TO DETERMINE THAT THE
SOFTWARE IS SUITABLE FOR USE.
•
EXPORT RESTRICTIONS
with all applicable international and national laws that apply to Windows 8 Embedded, including the U.S. Export
Administration Regulations, as well as end-user, end-use and country destination restrictions issued by U.S. and
other governments. For additional information on exporting Windows 8 Embedded, see http://
www.microsoft.com/exporting/
•
The bk3000 and bk5000 Ultrasound Systems are closed. Any modification of or installation of software to the
system may compromise safety and function of the system. Any modification of or installation of software without
written permission fromBK Medical will immediately void any warranty supplied by BK Medical. Such changes
will also void any service contract and result in charges to the customer for restoration of the original bk3000 or
bk5000 Ultrasound System.
. THE SOFTWARE IS NOT FAULT TOLERANT. BK Medical HAS
. You acknowledge that Windows 8 Embedded is of US-origin. You agree to comply
Trademarks:
DICOM® is the registered trademark of the National Electrical Manufacturers Association for its standards
publications relating to digital communications of medical information.
®
Curve
, Kick® and Buzz® are registered trademarks of Brainlab.
Microsoft
countries.
Pro Package is a trademark of BK Medical.
®
and Windows® are registered trademarks of Microsoft Corporation in the United States and other
bk3000 & bk5000 = Ref. Type 2300
© 2018 BK Medical
Information in this document may be subject to change without notice.
Contents
Chapter 1 Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Chapter 2 The User Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Working with the Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Selecting a Transducer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Selecting an Examination Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Document Browser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Measurements and Image Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Workflow Tabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Keyboard Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Chapter 3 Controls on the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Chapter 4 Working with the Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Selecting the Imaging Plane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Freezing the Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Partial Freeze and the Update Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Split Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Simultaneous Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Linked Split/Dual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Labels and Bodymarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Bodymarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Cine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Using Cine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Using Cine in M-Mode or Doppler Mode . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Video Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
The Video Window and Picture in Picture (PiP). . . . . . . . . . . . . . . . . . . . . . . . . 35
Using the Video Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Using PiP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Chapter 5 Making Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Measurements and Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Making a Measurement – General Procedure . . . . . . . . . . . . . . . . . . . . . . . 39
B-Mode and Color Mode Measuring Tools . . . . . . . . . . . . . . . . . . . . . . . . . 40
Doppler Mode Measuring Tools. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Chapter 6 Documentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
What are Documents? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
HIPAA Compliance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Saving Documents – Capturing Images and Video Clips . . . . . . . . . . . . . . . . . . 51
Capturing 2D Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Video Clips – Capturing while Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Capturing 3D Data Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
3
Saving Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Local Patient Archiving System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Reviewing Documents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
The Document Browser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Viewing and Editing Video Clips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Viewing Exported Documents on the System . . . . . . . . . . . . . . . . . . . . . . . 55
Viewing Exported Documents on an External Computer . . . . . . . . . . . . . . 56
Exporting Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
HIPAA Compliance and Exporting Data . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Copying to a CD/DVD or USB Storage Device. . . . . . . . . . . . . . . . . . . . . . 57
Archiving to a CD/DVD or Network Drive . . . . . . . . . . . . . . . . . . . . . . . . . 58
Using CD/DVDs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Using USB Storage Devices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Using a Network Drive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
The Archive Window (Examination List and Patient Information) . . . . . . . . . . 61
Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Examination List. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Deleting Documents or Exams from the System . . . . . . . . . . . . . . . . . . . . . 64
Starting a New Examination from the Examination List . . . . . . . . . . . . . . . 65
Pausing and Later Resuming an Examination . . . . . . . . . . . . . . . . . . . . . . . 65
Password Protection of the Patient Archiving System . . . . . . . . . . . . . . . . . 66
Hard Disk Quota. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Creating a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Editing a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Printing a Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Saving a Report to the Local Patient Archiving System . . . . . . . . . . . . . . . 69
Printing Documents or Images on the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Printing Thumbnail Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Printing Images Displayed on the Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . 70
Using a Transducer Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Chapter 7 Imaging Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Imaging Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Adjusting the Thermal Index Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
B-Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Focus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Auto Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Zoom. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Gray Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Combination Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Tissue Harmonic Imaging (True Echo Harmonics – TEH) . . . . . . . . . . . . . 77
Contrast Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
X-Shine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Activate X-Shine Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Adding Buttons to the Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Color Mode and Power Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
4
Color Submodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Color Coding of Flow. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Independent D-Mode/C-Mode Steering . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Color Box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Color Scales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Elastography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Color Box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Color Map. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Quality Indicator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Strain Ratio Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Diameter Comparison Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Vector Flow Imaging (VFI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Using VFI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Arrow Flow Indicators for VFI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Streamlined VFI Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Assisted Doppler Gate Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Angle Correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Assisted Doppler Steering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Inverting the Doppler Spectrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Selecting the Appropriate Scale/PRF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Assisted Volume Flow Rate Estimation. . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Asymmetric Doppler Gate Cross . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Outline of VFI Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Doppler Mode – Spectral Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Turning Doppler Mode On or Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Adjusting the Doppler Mode Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Doppler Indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Independent D-Mode/C-Mode Steering . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Doppler Trace (Automatic Curve Tracing) . . . . . . . . . . . . . . . . . . . . . . . . . 97
Sweep Speed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
M-Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
The M-Mode Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
M-Mode Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
M-Mode Image Ruler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Saving a Preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Chapter 8 Continuous Wave Doppler Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Adjusting the Thermal Index Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Adjusting MI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Turning CW Doppler Mode On or Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
CW Doppler Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Audio Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Adjusting the Doppler Mode Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Doppler Trace (Automatic Curve Tracing) . . . . . . . . . . . . . . . . . . . . . . . . 103
Auto . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Smooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
5
Wall Filter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Invert. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Baseline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Sweep Speed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Chapter 9 Pro Packages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107
Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
If You Perform a Puncture Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
What Is a Pro Package? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Doppler Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Stenosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
VF (Volume Flow) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
TAM (Time Average Mean) and TAMX (Time Average Max) . . . . . . . . 111
RI and PI (Resistance Index and Pulsatility Index) . . . . . . . . . . . . . . . . . . 112
Real-Time Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Noise Limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Carotid Velocities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Using the Brachy Pro Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Patient Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Calculating Volumes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Performing a Biopsy or Puncture Procedure (including Brachytherapy). . 118
Using the OB, Gyn, and Gyn Follicles Pro Packages . . . . . . . . . . . . . . . . . . . . 120
Gestational Age and Expected Date of Confinement. . . . . . . . . . . . . . . . . 120
Patient Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Making Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Calculation Methods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Obstetrics Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Chapter 10 Vascular Pro Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125
Contents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Setting up the Patient – Patient ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Imaging Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
B-Mode (2D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Color Mode (CFM). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Volume Flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Annotations – Labels and Bodymarks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Bodymarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Measurements and Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Using the Calculation Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Using Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Capturing and Documenting Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Cine Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Capturing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
6
Copying and Archiving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Customization Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
New Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Default Pro Packages and Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Making a New Screen Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Vascular Measurement Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Leg Vein Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Artery Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Where to Find More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Chapter 11 Cardiac Pro Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
Contents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Setting up the Patient – Patient ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Imaging Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
B Mode (2D). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
M-Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Color Mode (CFM). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Spectral Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Annotations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Bodymarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Measurements and Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Basic Cardiac Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
LVV (Left Ventricular Volume). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148
Doppler Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
HR (Heart Rate) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Cardiac Output . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Using Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Capturing and Documenting Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Cine Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Capturing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Copying and Archiving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Printing Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Customization Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Creating a Custom Keyboard Key for M-Mode. . . . . . . . . . . . . . . . . . . . . 155
Customizing Labels and Bodymarks Using Advanced Mode . . . . . . . . . . 155
FATE (Focus Assessed Transthoracic Echocardiography) . . . . . . . . . . . . . . . . 156
Preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
FATE Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Where to Find More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Chapter 12 Urology Prostate Pro Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Diagnostic Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Setting up the Patient – Patient ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Imaging Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
7
B Mode (2D). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160
Annotations – Labels and Bodymarks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162
Customizing Labels and Bodymarks Using Advanced Mode . . . . . . . . . . 163
Bodymarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Measurements and Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Automatic Measurement of Prostate Volume . . . . . . . . . . . . . . . . . . . . . . 165
User Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Capturing and Documenting Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Cine Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Capturing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Copying and Archiving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Printing Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Customization Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
New Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Default Pro Packages and Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Where to Find More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Chapter 13 Surgery Pro Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171
Contents. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Diagnostic Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Setting up the Patient – Patient ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Imaging Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
B-Mode (2D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Color Mode (CFM). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Elastography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Annotations – Labels and Bodymarks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Bodymarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Measurements and Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Freehand Measurements – Area and Circumference . . . . . . . . . . . . . . . . . 176
Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Using Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Capturing and Documenting Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Cine Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
The Document Browser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Capturing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Copying and Archiving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Printing Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Customization Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
New Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Default Pro Packages and Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Making a New Screen Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Customizing Labels and Bodymarks Using Advanced Mode . . . . . . . . . . 181
Where to Find More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
8
Chapter 14 Neuro Pro Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183
Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Diagnostic Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Setting up the Patient – Patient ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Imaging Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
B Mode (2D). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Color Mode (CFM). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Elastography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Annotations – Labels and Bodymarks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Bodymarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
Measurements and Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Freehand Measurements – Area and Circumference . . . . . . . . . . . . . . . . . 189
Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Using Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Capturing and Documenting Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Cine Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
The Document Browser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
Capturing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Copying and Archiving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Printing Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Customization Examples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
New Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Default Pro Packages and Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Making a New Screen Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193
Customizing Labels and Bodymarks Using Advanced Mode . . . . . . . . . . 193
Imaging with Brainlab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194
Contact with the Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194
Installation and Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194
Spinal Cord Pro Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Where to Find More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Chapter 15 3D Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197
Introduction to 3D Ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
3D License. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
Controlling Transducer Movement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
System-Controlled Positioning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
The 20R3 Transducer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
The Magnetic Wheel Mover. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
Untracked Freehand Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
3D Imaging Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Preparations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200
Adjusting the Image Capture Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
ROI (3D Region of Interest). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
3D Capture Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
Viewing a 3D Data Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
9
Enhancing a 3D View. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
3D Layout Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Working with the 3D Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Manipulating the Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
Annotating a 3D View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
User Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
The 6 Data Presentation Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
Cube View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Render View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
MIP View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Transparency View. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
4-Up View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
6-Up View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
Save, Capture and Close . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
Chapter 16 DICOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
DICOM on the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
New Patient Information from a DICOM Worklist . . . . . . . . . . . . . . . . . . . . . 213
Saving or Printing to a DICOM Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Filenames of Documents Exported in DICOM Format . . . . . . . . . . . . . . . 213
Archiving to a PACS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214
Deleting a Document . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Discontinuing an Examination with an MPPS Server . . . . . . . . . . . . . . . . 215
Appendix A Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217
Appendix B Measurement Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223
Appendix C Setting Up and Customizing Your System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Pro Package and Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
Doppler and M-Mode Monitor Layout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
User-Defined Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245
Assigning User-Defined Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Customizing Key Brightness, Mouse Controls and Depth Control . . . . . . 247
System Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
General Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Clip Storage and Cine Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
3D Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Printer Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253
Password Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Network Archiving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Version Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
Video I/O Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
Battery Support Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
Miscellaneous System Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260
Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
User-Defined Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
Curves. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
10
Miscellaneous Measurement Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
Marks (Bodymarks, Labels, Puncture Guides) . . . . . . . . . . . . . . . . . . . . . . . . . 272
Bodymark Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
Label Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
Transperineal Matrix, Brachy Matrix and Ruler, and Programmable Puncture
Guide Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Miscellaneous Marks Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Licenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
Importing and Exporting System Configurations . . . . . . . . . . . . . . . . . . . . . . . 280
Importing or Exporting Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
DICOM Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
Appendix D Redefining Screen Keys – Label, Bodymark, and Measurement. . . . . . . . . . . . . 287
Other Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Appendix E Configuring the bk3000 and bk5000. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Before You Begin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Configuration Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Key Definitions (Redefining an Existing Key) . . . . . . . . . . . . . . . . . . . . . 291
Unavailable Spaces. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
The Imaging Tabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Special 3D Mode Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Measure and Mark Tabs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Documentation Tab . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294
Patient Dialog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Display Areas and Info Boxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Prioritizing the Display of Measurements and Settings . . . . . . . . . . . . . . . 297
Creating a New Pro Package in Configuration Mode . . . . . . . . . . . . . . . . . . . . 297
Index 299
English Source Version
16-01487-01
11
12
Chapter 1
Before You Begin
This is the advanced user guide for the bk3000 and bk5000 Ultrasound Systems.
The
bk3000 & bk5000 User Guide
available for the system, including different user guides.
includes an overview of all the documentation
NOTE:
You must read the Safety chapter in the bk3000 & bk5000 User Guide before
working with the system.
This guide takes you deeper into the functionality and potential of the bk3000 and
bk5000 Ultrasound Systems.
NOTE:
Some of the functionality and options described in this guide may not be
available with your version of the system.
Questions About the System Where to Find the Answers
What are the various parts of the monitor
display?
Is there an alphabetical list of all the
controls on the system?
How do you make measurements and
calculations for an image, and what
measurement tools are available?
How do you manage the images, clips, 3D
data sets, and reports that are made on the
system?
What imaging modes are available on the
bk3000 and bk5000?
“The User Interface” on page 15
“Controls on the Monitor” on page 21
“Making Measurements” on page 39
“Documentation” on page 51
“Imaging Modes” on page 71 and “3D
Imaging” on page 197
What is an examination type, and how does
it help with imaging?
How does DICOM
and bk5000?
What do various abbreviations mean?
Can the bk3000 and bk5000 be customized
and how?
How do you configure the system?
bk3000 & bk5000 Advanced User Guide
®
work with the bk3000
(16-01487-01) Before You Begin
“Pro Packages” on page 107
“DICOM” on page 213
“Glossary” on page 217
“Setting Up and Customizing Your System”
on page 243, and “Redefining Screen Keys –
Label, Bodymark, and Measurement” on
page 287,
“Configuring the bk3000 and bk5000” on
page 291
13
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Chapter 2
Imaging
mode tabs
Advanced key
Select
transducer
Select exam type Enter patient information
Documentation
panel or browser
Measurement
data
Image data
Workflow tabs
The User Interface
Working with the Monitor
This chapter introduces you to each part of the monitor (Fig 2-1).
For a description of the keyboard, see
The first 3 steps for imaging are:
1
Select a transducer.
2
Select an examination type.
3
Enter the patient information.
You work in the upper part of the monitor to perform these steps, as shown in Fig 2-1.
Getting Started with bk3000 & bk5000
.
Figure 2-1. The monitor user interface for the bk3000 and bk5000.
Selecting a Transducer
On the drop-down menu, select the transducer that you will use for imaging. Only
transducers properly connected to the system appear on the list.
bk3000 & bk5000 Advanced User Guide
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15
Selecting an Examination Type
Pro Package
Defines monitor setup
such as tabs, screen
controls, measurements,
labels, bodymarks,
reports. Yellow (Uro
Prostate) indicates the
chosen Pro Package.
Preset
Defines settings for image
processing such as
transducer frequency, gain,
etc.
1. Click Pro Package...
2. Choose from the
list of other Pro
Packages for
additional
measurements,
labels, etc.
The examination type configures your monitor for imaging. An examination type
consists of a Pro Package (predefined monitor settings) and a preset (predefined
image processing settings). The names of the examination types indicate where they
are best suited: urology, gynecology, and so on.
NOTE:
Pro Packages are indicated by brighter white text. Yellow text indicates the
selected Pro Package and preset (Uro Prostate and Prostate M in this picture).
NOTE:
A measurement that is set up for one preset in a Pro Package will be available
in all presets for that Pro Package.
If you need access to measurements or functions available in other Pro Packages, you
can click the Pro Package name instead of a preset name. This will not affect the
image setup itself.
The list of Pro Packages displayed depends on which transducers are connected to
the system. If the Pro Package you need is not listed, click
Figure 2-2. Finding a Pro Package from the list of all Pro Packages.
Pro Package...
For information about examination types, see Chapter 9, “Pro Packages” on
page 107.
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Patient Information
After you select the transducer and exam type for your imaging, click the patient
information area at the top of the monitor. (It might say
patient name or the current time and date). You can also press the
Enter Patient
Patient
keyboard. A window opens where you can enter patient information. The fields that
are available for entering patient information depend on the examination type.
NOTE:
If you are capturing an image or clip, or using 3D, you must enter a patient
name and ID.
You can configure the patient information area to show the information you want.
See Appendix E, “Configuring the bk3000 and bk5000”.
Document Browser
For information about using the Document Browser, see Chapter 6,
“Documentation” on page 51.
Measurements and Image Data
For information about making and using measurements on the system, see Chapter 5,
“Making Measurements” on page 39.
or contain a
key on the
For information about working with the image, see Chapter 4, “Working with the
Image” on page 29.
If measurement data are covered by workflow tabs, minimize the tabs by clicking the
top tab.
You can customize which measurement and image data are displayed, where they are
displayed on the monitor, and the font size for measurements. For more information
about this customization, see Appendix E, “Configuring the bk3000 and bk5000” or
consult your BK Medical representative.
Workflow Tabs
Workflow tabs follow the typical workflow of a patient examination. The workflow
tabs open automatically as needed so that only relevant controls are displayed.
The tabs are at the bottom of the monitor and are often minimized when you start the
system. Click to open them up.
•
The
Image
tab is on top when you are imaging.
•
When you freeze an image, the
measurements or annotations.
•
When you want to copy, print, or archive documents, or make a report, open the
Documentation
tab.
Measure and Mark
tab opens so you can make
Minimize all tabs by clicking the top workflow tab. Maximize all tabs by clicking
any tab. To open a workflow tab that is not on top, click it.
Most on-screen controls are grouped and displayed as screen keys on the appropriate
workflow tabs. You can click a tab to see its controls.
bk3000 & bk5000 Advanced User Guide
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17
Advanced
By default, only the controls relevant for the situation are displayed.
Click
Advanced
to display
all
available controls for any of the tabs.
NOTE: Advanced
must be on to access
Customize
, which is where you configure
settings as described in “Setting Up and Customizing Your System” on page 243.
The Image Tab
The
Image
Screen keys on the
visible at the top of the workflow tab. Click on an imaging mode tab to open it and
see and use its keys.
NOTE:
it and use its keys. If you click the imaging mode tab that is on top, you turn off that
imaging mode.
The imaging mode subtabs for
•
•
•
•
NOTE:
examination type is set up to include that mode.
tab is on top when you start to image.
Image
workflow tab are grouped on various imaging mode tabs,
If an imaging mode tab is active, but its tab is not on top, click the tab to open
Image
are:
General: controls for B-mode
Color: controls for color mode and power mode
Doppler: controls for spectral Doppler mode
M-mode: controls for M-mode.
An imaging mode tab (for example, M-mode) is available only when the
Capturing a 3D data set is initiated by the 3D key on the keyboard or by the 3D
controls on the
Image
tab.
3D Tab
Viewing and manipulating a 3D data set can be considered virtual imaging – an
additional step in the workflow. When you have captured or recalled a 3D data set, a
3D workflow
tab appears. It may be divided into 2 subtabs, which appear at the top
of the tab area, similar to imaging mode tabs.
For information about 3D imaging, see Chapter 15, “3D Imaging” on page 197.
Measure and Mark Tab
The
Measure and Mark
It contains controls for the measurements and annotations that are set up for the
examination type.
Click
More Meas., More Bodymarks
or annotations than are immediately shown on individual screen keys.
The down arrow on the right of a screen key indicates that clicking the key opens a
menu to choose from.
tab opens when you freeze the image.
or
More Labels
to see more measurements
NOTE:
The
More
screen keys are only visible when
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Advanced
bk3000 & bk5000 Advanced User Guide
is on.
(16-01487-01)
Figure 2-3. The More screen keys on the Measure and Mark tab.
If the
Measure and Mark
tab does not contain a screen key you need, you can
redefine one of the screen keys. (See Appendix D, “Redefining Screen Keys – Label,
Bodymark, and Measurement”.)
You can access any measurement from
any
measurement screen key.
To access any measurement:
1
Click
Advanced
2
Click the circle in the top right corner of a key to open the
and click the
.
word(s)
Key Definition Menu
that name the measurement, not the
circle
Appendix D, “Redefining Screen Keys – Label, Bodymark, and
Measurement”.)
This is handy for a measurement that is used only occasionally.
You can do the same thing for label and bodymark screen keys.
Documentation Tab
After acquiring the image and making measurements, use the
for saving, reviewing, or deleting the images and reports you made.
Documentation
next to it. (See
tab
bk3000 & bk5000 Advanced User Guide
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19
Keyboard Control Panel
The keyboard control keys are described in
Getting Started with bk3000 & bk5000
Typing Special Letters or Accents
Some special letters are available as keys on the keyboard. In addition, 4 accents are
available on the
Figure 2-4. The Accent key.
To use accents, press the
Examples:
To write this Press this Then press this
ö or (Ö)
è or (È)
ñ (or Ñ)
ê (or Ê)
Accent
key.
Accent
Accent
Shift + Accent
fn+ Accent
Shift + fn+ Accent
key and THEN press the letter that is to be accented.
o
(or
e
n
e
(or
(or
(or
Shift + o
Shift + e
Shift + n
Shift + e
, for O)
, for E)
, for N)
, for E)
.
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Chapter 3
Controls on the Monitor
This chapter contains a list of all on-screen controls in alphabetical order. Some onscreen controls only appear when
been set up to display them. See Appendix C, “Setting Up and Customizing Your
System” and Appendix D, “Redefining Screen Keys – Label, Bodymark, and
Measurement”. Not all of the controls in the list can be configured by the user.
Monitor Control Function
Advanced
is turned on or when the system has
%d ]
[ %d
2D Filter
3D
3D Frames
ACI
Advanced
All
Angle
Archive
Area
Arrow
Set the frame number for the end of a cine loop.
Set the frame number for the beginning of a cine loop.
Set amount of color information smoothing in Color or Power mode.
Turn 3D imaging on or off.
Display the number of frames.
Turn Angular Compound Imaging on or off to reduce speckle and optimize the ultrasound
image. ACI is only supported for some transducers.
NOTE:
If ACI is turned on, you cannot select number of focal zones.
Make all available controls on a tab visible.
Select all documents in the browser.
In Doppler mode, correct the Doppler angle.
In 3D, measurement of angle.
Send to PACS (DICOM), to a network drive, or to a staging area to be burned to a CD/DVD.
3D area measurement.
Display an arrow on the image.
Auto
Autofocus
Auto Scale
B Color
Biopsy
Bodymark
bk3000 & bk5000 Advanced User Guide
In B-mode, reset overall gain and TGC curve to the default setup for the preset.
NOTE:
curve on the monitor may not correspond to the relative position of the sliders on the
control panel.
In Doppler mode, reset the range and baseline to prevent aliasing and to optimize the
display of the Doppler spectrum.
NOTE:
are being adjusted. This may take a few seconds.
Ensure that the focal range is centered in the displayed image.
Automatic Scale/PRF adjustment.
Select a color to tint the B-mode image.
Display a puncture line or brachy matrix.
Place a bodymark on the image.
The TGC sliders do not move when you do this. Therefore, the shape of the TGC
The keyboard, except for the
(16-01487-01) Controls on the Monitor
Freeze
21
key, is disabled while the scale and baseline
Monitor Control Function
Brightness
Burn CD ...
C Baseline
Cancel
Capture
Capture Multiple
Clips
CFM Steer
Cine Play
Clear All
Close
Color Level
Color Off
Adjust monitor brightness.
Burn documents from the staging area to CD/DVD.
Reposition the Color mode baseline (offset the Doppler color scale) to help with aliasing
problems.
Cancel the current procedure or action.
Save image (if image is frozen) or clip (if imaging) to system hard disk. You must have
entered a patient ID to do this.
Start capturing a sequence of a pre-defined number of clips.
Change color box steering angle in Color and Power mode.
Play a cine loop.
Clear all measurements, labels, and annotations or 3D sculpting.
Close the 3D Viewer.
Adjust color level in the 3D Viewer.
Remove the color (flow information) while you are imaging in Color or Power mode. Use
this to remove the color temporarily, while keeping the Color box and other settings.
Color Prty
Copy
Cube
Customize
D Baseline
Delete
Depth
Depth -
Depth +
D. Freq.
Direction
Adjust the priority given to color (flow information). High color priority gives color in more
areas; low color priority reduces the number of areas that are colored.
Copy the selected images to a CD/DVD or USB memory device. An option is available to
copy without Patient ID. For HIPAA compliance, this option is recommended.
3D Cube view.
Open setup windows for customizing the system.
Reposition the Doppler mode baseline to help with aliasing problems. The frequency axis
is updated to match the spectrum.
Delete the documents selected in the browser.
Adjust depth. In 3D, adjust sculpting depth.
Decrease maximum tissue depth shown (increase image magnification). You can configure
this so that it decreases magnification.
Increase maximum tissue depth shown (decrease image magnification). You can configure
this so that it increases magnification.
Change Doppler frequency.
Set direction of a 3D data acquisition.
Display
Display 3D sculpture.
Sculpture
Distance
Doppler Depth
22
Chapter 3 November 2018
Measure distance in 3D.
Doppler Gate depth.
bk3000 & bk5000 Advanced User Guide
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Monitor Control Function
Dyn. Range
Edge
End Exam
ETD
Exam List
Extended Res.
Extent
Filter
Frame
Freeze/
Unfreeze
Adjust contrast (dynamic range). Lower dynamic range = higher contrast. Higher dynamic
range = lower contrast.
Edge enhancement. Emphasize contours in B-mode image so that edges stand out more
clearly.
End current examination.
Enhanced Tissue Definition (speckle reduction algorithm). ETD can be set at 5 different
levels ranging from subtle speckle reduction (level 1) to strong reduction (level 5). The
default level is 3; level 0 turns ETD off.
NOTE:
ETD is not applied to M-mode image when imaging in B+M mode.
Open the
Examination List
in the
Archive
window.
Extended Resolution. Obtain better spatial resolution of the image at the cost of a lower
frame rate.
Set extent of a 3D data acquisition.
Adjust 3D Filter.
Select a frame of the cine clip.
Freeze all images on the monitor or start imaging (image update) again.
Freq (B Freq,
C Freq, P Freq)
Full Size
Gain (B Gain,
C Gain, P Gain,
D Gain, M Gain)
Gray Level
Harmonic
Hospital Name
Hue
Import Licenses
Invert
Join
Select imaging (transmitted) frequency (B-mode or Doppler). The current B-mode imaging
frequency is displayed on the screen key. (If harmonic imaging is turned on, the displayed
frequency (H) is the receiving frequency.
Maximize the size of the image.
Lighten or darken the image in the different imaging modes. When image is frozen, use
Post Gain.
Adjust gray level in 3D viewer.
Tissue harmonic imaging on and off. When you turn it off, B-mode imaging resumes with
the frequency, gain, dynamic range, and so on, that you were using previously.
On the image tab, click
Advanced
. On the
System
tab, enter name of hospital or
institution.
Adjust hue in 3D viewer.
Import license keys from a file.
In Color mode, invert color coding of flow information so that flow towards the transducer
appears blue and flow away from the transducer appears red. In Doppler mode, invert the
spectrum on the monitor.
Join 2 clips.
L/R
Label
Layout
bk3000 & bk5000 Advanced User Guide
Change the left-right image orientation of all modes in the selected view.
Select a label to put on the image.
Set the layout for a Doppler/M-mode split screen: vertical or horizontal.
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23
Monitor Control Function
Lines
Login .../Logout
Luminance
Measurement
Line Size
MI
More
Multibeam
Needle Strength
New
Next
You can select the line density of the ultrasound image for B-mode, Color mode, and Power
mode.
NOTE:
You can set different line densities for a mode used (by itself, in the case of B-mode)
or in different combinations.
Log on to and log out of the network using network username and password. Requires that
password protection is enabled.
Adjust luminance in 3D Viewer.
Select measurement line size.
Set the maximum allowed mechanical index.
On the
(
Measure and Mark
Advanced
must be on to view the
tab, display additional measurements, bodymarks, or labels.
More
buttons.)
Increase the frame rate or the line density by receiving signals from several directions.
Adjusts the visibility of the needle. As you increase the needle strength, the image quality
is reduced. Note that this button will only be visible when
X-Shine
is on.
New 3D volume.
Go to next volume slice.
New Exam
Noise Cutoff
Noise Limit
Noise Reject
None
Number of
Angles
Opac
Orientation
Pan
Patient ID
and
Patient Name
Patients with at
least one exam of
type...
Start new examination.
Setup of color map in B-mode.
Change the noise limit. You can reduce the noise (high frequency disturbances) in the data
to improve the accuracy of automatically traced curves. Low noise limits cut out less noise;
high limits cut out more.
Reduce noise in the image, particularly in vascular imaging.
Deselect all documents in the browser.
Set the number of angles for angular compound imaging (ACI).
Specify the transparency (opacity) of a structure in 3D rendering view.
Display or hide orientation markers in 3D volumes.
Double-click in the image to select and drag it.
Individual patient ID (such as social security no.).
NOTE:
You must enter a patient ID to capture an image or clip, or to use 3D. Patient name
and ID are saved in the patient archive.
Search entry in patient archive. The types are: Image, Clip, 3D and Report.
Pause Exam
Persist
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Chapter 3 November 2018
Pause an exam.
Set the persistence level of the ultrasound image in B-mode, Color mode, and Power mode.
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Monitor Control Function
Photo
Plane
Play
Post Gain
Preset
Presets
Prev
Print
Pro Package
Real-Time
Redo
Report
Res/Hz
Adjust the photorealistic parameter used in 3D rendering view. This can only be used on
gray scale volumes.
With biplane and multiplane transducers, toggle between imaging planes.
Play cine loop.
Adjust the gain of a frozen image. See Gain.
Select a preset.
Open menu of presets for enhanced viewing of 3D volumes.
Go to previous volume slice.
Print the selected documents.
Select a Pro Package.
Turn Real-Time measurements on and off, and select the one you want.
Redo measurements and annotations.
Open a report for the current examination.
Shows the balance between resolution and frame rate. Higher resolution number means
higher resolution, lower resolution number means faster frame rate.
Reset
Rest Position
Sample Volume
Save...
Scale
Sculpture
Shots Per Est.
Simultan
Size
Smooth
Reset the preset to the factory default values.
3D acquisition rest position.
Resize the Doppler gate to change the area over which Doppler information is collected.
Save the current setup as a new preset.
Vary the PRF (pulse repetition frequency) to select the range of Doppler velocities
(frequencies) that are displayed in the spectrum and/or color-coded. Restricting the range
allows you to see velocity differences (within the range) in more detail.
NOTE
: The wall filter value will be changed automatically when you change the PRF value.
Turn sculpting of the 3D cube on and off.
Adjust the number of pulses transmitted in each waveform packet at the expense of
decreasing the frame rate.
NOTE
: The Color mode shots may not be the same in B+Color mode as in
B+Color+Doppler. Similarly, the Power mode shots may not be same in B+Power mode as
in B+Power+Doppler. Changes you make in one case will not affect the other case.
Set split-screen view to images simultaneously. (Color or Power mode can be in only one of
the views.)
Make the image bigger or smaller.
Set how much smoothing is applied to the displayed Doppler spectrum.
Spacing
Span
Speed
bk3000 & bk5000 Advanced User Guide
Set spacing of a 3D data acquisition.
Set the extent of the rotation of a 3D volume.
Set the speed of the cine movie.
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25
Monitor Control Function
Split
Steering
Step
Store Image on
PAC S
Submode
Sweep
Sync. Steer
Thickness
Time
Timer
Tra ce
Transducer
Split the screen horizontally or vertically to display 2 imaging views at the same time.
Change the Doppler beam angle in Color, Power, and Doppler modes.
Set the volume measurement step size.
Store the image on a PACS (Picture Archiving and Communications System).
Select Color or Power submode.
In D-mode, set the sweep speed to change the number of cycles of the spectrum displayed
on the full time axis. In M-mode, set the speed at which the M-mode image sweeps across
the monitor.
Independent D-mode/C-mode steering.
Set thickness in photo and non-photo mode in 3D.
Set duration of a 3D data acquisition.
Start or stop a timer on the monitor.
Activate automatic Doppler curve tracing and specify the type: Peak, Mean+Peak, or Mean.
NOTE:
Real-Time measurements must be turned on. See Real-Time.
Select a transducer.
U/D
Undo
Update
USB Eject...
User Views
VF (real-time)
Video Setup...
View
Volume
Wall Filter
Change the up-down image orientation of all modes in the selected view.
NOTE:
When you change image orientation, you may need to adjust the TGC settings for
the B-mode image.
Undo latest action for measurements, annotations, or sculpting.
See update on control panel. Toggle between B-mode and Doppler.
Click to eject USB device (flash memory) safely – the system then notifies you when it is safe
to remove the device without risk of losing data. If more than one USB device (flash
memory) is connected, all will be ejected.
Open a menu of user-defined views in 3D volume.
Activate assisted volume flow estimation.
Adjust video-in settings.
On the
Documentation
tab, view the selected document from the document browser.
In 3D mode, select how the 3D volume is displayed.
Adjust the volume of the audio signal in Doppler mode.
In 3D, measure 3D volume.
Turn the wall filter on (in Color, Power, or Doppler mode) and set the cut-off frequency.
Width
Narrowing the image width allows for greater frame rate without a loss of image resolution.
With some transducers, you can increase the width beyond 100% to expand the field of
view.
Wire Frame
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Chapter 3 November 2018
Display wire frame on 3D volume.
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Monitor Control Function
X-Shine
X-Shine Toggle
Zoom
Activates the X-Shine function for best needle visibility. Select between On+, On- and Off
on the slider.
Activates the X-Shine function for best needle visibility. Toggle between On+, On- and Off.
Zoom 3D volume.
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Chapter 4
Working with the Image
Depending on which system you have, you can work with an image (measuring,
resizing, etc.) using
•
The trackball and its keys to point or click and drag.
•
Special keys on the keyboard.
•
The keyboard (the physical keyboard or the on-screen keyboard).
Selecting the Imaging Plane
If you are using a transducer with more than one plane, you can select the imaging
plane (T for transverse, S for sagittal, or E for endfire). The current imaging plane
T, S, or E
(
To select the imaging plane:
•
) is displayed at the top of the monitor next to the transducer type number.
Press the appropriate button on the transducer. For details, see the user guide for
the transducer.
or
•
Click T,
want.
or
•
Press the
NOTE:
When you change image orientation U/D, you may need to adjust the TGC
settings for the B-mode image. See “TGC” on page 73.
Freezing the Image
When you press the
and a snowflake appears on the monitor. If you press
to its previous state.
NOTE:
Some functions are not available when the image is frozen and some are
available
(indicating that it is unavailable), try freezing or unfreezing the image.
When you freeze the image, the date and time displayed on the monitor are also
frozen, so the time displayed on a printed image is the time the image was frozen, not
the time it was printed.
only
S, or E
(whichever is displayed) on the monitor and select the value you
Scanning Plane
Freeze
when the image is frozen. If a control you want to use is dimmed
key or click
key or click
Plane
Freeze,
to toggle through the planes.
all images on the monitor are frozen
Freeze
again, the image returns
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29
Partial Freeze and the Update Key
You can only do a partial freeze when you are imaging in Doppler mode as well as
one or more 2D modes (B-mode, color, and power) – duplex or triplex imaging. In
partial freeze,
toggle between the two images in a partial freeze.
To start partial freeze:
•
Press the
The partial freeze state starts with all 2D-modes frozen and Doppler mode
imaging.
either
the Doppler image or the 2D-mode image is frozen. You can
Update
key.
Split Screen
While the partial freeze is active, press the
Update
key to toggle the display between
the 2 states, which are
•
Doppler mode frozen; 2D-modes imaging.
•
2D-modes frozen; Doppler mode imaging.
To unfreeze both views:
•
Long press the
Update
key.
You can split the screen horizontally or vertically to display 2 views side by side or
one over the other.
•
If you are using a single-plane transducer, the 2 views contain the same imaging
view.
•
If you are using a biplane transducer, each view displays the image from one
imaging plane.
•
If simultaneous imaging is turned on, both views can be imaging.
To split the screen or remove a split:
•
Click
Split
and select
Ver ti ca l, Horizontal
, or
Off
(or long press the
Split
key).
NOTE:
In the Uro Prostate Pro Package, you cannot select split orientation. The
screen key works like the
To select one of the views:
•
Click in the view you want to select (or press the
Simultaneous Imaging
The 2 views in a split screen can both be imaging simultaneously; in this case,
freezing and unfreezing affect both images.
To turn simultaneous imaging on and off:
•
Click
Simultan
NOTE:
In simultaneous split-screen imaging, only one of the views can contain Color
or Power mode. Therefore, if one view has B+Color or B+Power, the other view
contains only a B-mode image.
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Chapter 4 November 2018
.
Split
key on the keyboard.
Split
key).
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Split
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You can save a simultaneous split setup (which image is in which part of the monitor)
as part of a preset.
Linked Split/Dual
Linked Split/Dual is enabled as a default setting on all Pro Packages. During split
screen imaging, the Linked Split/Dual function automatically transfers the
parameters from screen A to screen B (and vice versa). Color and power mode can
be in only one screen.
To use Split/Dual:
1
Adjust the image parameters in screen A, then click screen B to transfer the
parameters.
2
Use the same method to transfer the parameters from screen B to screen A.
To disable Linked Split/Dual:
•
Click the
Interface)
Linked Split/Dual
button to [Off] on the GUI (Graphic User
NOTE:
The functionality of the Linked Split/Dual button can be saved as part of a
preset. This allows the user to add or remove the button from the GUI as desired.
NOTE:
In Linked Split/Dual imaging, only one of the views can contain Color or
Power mode. Therefore, if one view has B+Color or B+Power, the other view
contains only a B-mode image.
Labels and Bodymarks
In addition to annotating an image during an examination, you can add annotations
(labels and bodymarks) to archived images and to individual frames of archived clips
from the same type of ultrasound system.
NOTE:
Labels and bodymarks change color when being manipulated. They turn gold
when you are able to work with them. When they are blue, they can be moved. When
in position and the cursor is not nearby, they are gray.
Labels
Labels provide a practical way to identify or explain an image. You can:
•
Place text labels anywhere on the ultrasound image.
•
Add more than one label to an image.
•
•
To select a label:
1
bk3000 & bk5000 Advanced User Guide
Type labels directly on the image or select a pre-defined label. When you type,
labels are auto-completed from the list of pre-defined labels.
Change the label to have the opposite orientation word (right/left, up/down,
upper/lower, anterior/posterior).
On the
one you want, click
Measure and Mark
tab, click the label you want. (If you don’t see the
More Labels
(16-01487-01) Working with the Image
– visible when
31
Advanced
is on.)
2
Imaging plane indicator
Use the trackball to move the label and then click when it is in the correct
position.
To change an orientation word in a label to its opposite (right/left, up/down,
upper/lower, anterior/posterior):
1
Select the label.
2
Press +/- on the keyboard (either + or - will work).
The orientation word will be replaced by its opposite.
To move a label that you have already positioned:
•
Click it and drag it to the new position. Click again when the label is where you
want it.
To remove a label:
•
Long click the label you want to remove.
To edit a label on the image:
•
Click the label on the image and type the changes you want.
Bodymarks
Bodymarks are small bitmaps depicting parts of the body. You can place a bodymark
anywhere on the ultrasound image.
You can set up a user-defined key to place a frequently-used bodymark. See
“Assigning User-Defined Keys” on page 247.
An imaging plane indicator can be placed on the bodymark to show the imaging
position.
Figure 4-1. Bodymark with imaging plane indicator.
The imaging plane indicator consists of a long bar and small square. The orientation
of the bar indicates the orientation of the probe on the body, and the square indicates
the part of the probe that corresponds to the upper left of the image on the monitor.
Using Bodymarks
To place a bodymark on the image:
1
On the
the one you want, click
The bodymark appears on the monitor with an imaging plane indicator.
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Chapter 4 November 2018
Measure and Mark
tab, click the bodymark you want. (If you don’t see
More Bodymarks
– visible when
bk3000 & bk5000 Advanced User Guide
Advanced
is on).
(16-01487-01)
2
Drag and click the imaging plane indicator to position it; and use the
+/-
key to
rotate it.
To move a bodymark:
1
Click on or near it, so that the frame around it turns blue.
2
Drag it to the position you want, and click again.
To replace a bodymark:
To replace an existing bodymark with a different one, click the new bodymark on the
Measure and Mark
tab.
To remove a bodymark from the monitor:
•
Point at the bodymark and long click it.
Unless you delete it or replace it with a new one, a bodymark will remain on the
monitor until you change Pro Packages or begin to image a new patient.
Adjusting the Imaging Plane Indicator
To adjust the imaging plane indicator:
•
On the
Measure and Mark
tab, click the bodymark.
Cine
You can then
•
Drag the imaging plan indicator with the trackball
•
Rotate by pressing the
+/-
key
Click again when the imaging plane indicator is the way you want it.
Cine (image review) lets you review a series of the most recently recorded B-mode,
B+Color mode, B+M-mode, or B+Doppler mode images.
Freeze the image and turn the
B-Mode
key to scroll backward or forward through the
series.
Images are constantly being saved and stored for review. When storage capacity is
reached, the oldest images are discarded as new ones are stored. The number of
images that can be stored for review varies, depending on such factors as image
resolution and size.
Images in a clip must be comparable. Therefore, changing certain parameters that
affect the image will cause already-stored images to be discarded. If this happens,
there will not be a full set of images to be reviewed until the storage has had time to
fill again.
You can change some of the settings for the
changing Cine functions, see “Clip Storage and Cine Setup” on page 250.
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C
INE
function. For information about
33
Using Cine
Scroll here to
select a
particular frame
to view or to
scroll through
the images
3. Click here to play the clip as a
cine loop. Click again to stop it
1. Scroll here to select a
start or stop frame
Stop marker Start marker
2. Click here to set the frame
as start or stop frame
To use the Cine function:
•
Freeze the image, and when the
Advanced
Cine indicators are displayed at the upper right of the tab, depending on the
active ProPackage.
Measure and Mark
tab opens, click
.
Figure 4-2. Cine indicators.
NOTE:
The most recent image is number 1. In Fig 4-2, the frame indicator shows that
frame #1 of 749 frames is being displayed. The higher the number, the “older” the
frame.
Start and Stop Markers
Set the Start and Stop markers to indicate the range of images to be displayed in
. These markers are shown in Fig 4-2.
Play
NOTE:
The image chosen for the Start marker must be older (the Frame number must
be higher) than the image chosen for the Stop marker.
During
Cine Play
, the image with the highest frame number (oldest) is displayed
first, followed by images with decreasing frame numbers (newer). The current frame
and the total number of frames are displayed above
has been displayed,
Cine Play
will begin to play the loop again, starting with the
Frame
. After the newest image
highest frame number.
Using Cine in M-Mode or Doppler Mode
When cine is activated while imaging in M-mode or Doppler mode, a vertical cine
cursor is displayed overlaying the Doppler or M-mode image.
Cine
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Chapter 4 November 2018
The B-mode image displayed is always the one that corresponds to the position of
the Doppler or M-mode cursor. The image (frame) number in the
Frame
indicator
corresponds to the B-mode image.
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To make measurements on a cine image or save it:
1
When the desired image is displayed, click.
2
Make measurements on the image or save it in the usual way.
NOTE:
When you move a cine image after you make a measurement, the measurement
result remains, but the markers disappear (because the underlying image is
different).
Video Display
The image can be displayed on an auxiliary video monitor. You can select the video
output mode (including OFF). See “Video I/O Setup” on page 258.
The Video Window and Picture in Picture (PiP)
Picture in Picture (PiP) lets you view two types of images at the same time, on the
same monitor: an ultrasound image and a video image. The video image can come
directly from a camera (on endoscope, for example), or it can be played back from a
video recorder.
Using the Video Window
When you display a video image on the monitor (and are not using PiP), the video
image appears in a window that covers the ultrasound image and the on-screen
controls to the left of the image. This large window is called the
Video Window
.
To activate the video window:
•
Click
Video
.
To close the video window:
•
Click
Video
.
If you unfreeze the ultrasound image and PiP is not turned on, the video window
closes.
Changing the Video Setup
The video setup determines how the video image looks.
You can change the video setup while a video image is displayed in the video or PiP
window. You use the
connector on the system and the equipment that is attached to it). The video format
(PAL or NTSC) that is set in the
For information about the
To change the video setup:
•
Click
Video Setup.
The
Video Setup
Video Setup
window (Fig 4-3) to specify the video source (the
General Setup
Video Setup
window appears.
window also affects the video input.
window, see “Video Format” on page 249.
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35
Figure 4-3. The Video Setup window.
Change video brightness, contrast, and saturation here
(not available with RGB)
Click here to restore default settings for the
selected video source
Click here to save current settings as
default for the selected video source
Select video source here – an S-video connector can be
connected directly, but a composite connector needs an
adapter. See Connecting Other Equipment in the
bk3000 & bk5000 User Guide
NOTE:
The equipment names (Camera, VCR, AUX) are just labels so that you can
save setups for different equipment. If you plan to use three different composite video
cameras, then you can use one of the first three options in the table for each camera.
Using PiP
When you use PiP (Picture in Picture), there are two image windows on the monitor
– one large and one small. The
on the monitor is an ultrasound image, the PiP window contains an external video
image. If the main image is a video image, the PiP window contains an ultrasound
image.
PiP window
is the smaller window. If the main image
PiP must not
cover
important
information
WAR NI NG
PIP-1
When you use Picture in Picture, do not cover critical information (such as TI or MI) on the
monitor. Make sure that all important information will appear if you print or save the
ultrasound image.
If the PiP window is outside the image documentation area, it will not appear when
you print the image. You must make sure that the PiP window is in a suitable position
for your purposes.
NOTE:
If you archive images through DICOM, you cannot change them afterward. If
the PiP window covers part of the ultrasound image, you may not be able to make
accurate measurements on images archived through DICOM.
To display the PiP window:
•
Click
PIP
.
The contents of the PiP window when it opens depends on whether the video window
is active (open) when you turn on PiP.
Video Window PiP Window Contents
Not Active Video from external video signal
Active
Table 4-1. Contents of the PiP window when it opens.
Ultrasound image
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To turn off PiP:
•
Click
PIP
.
Adjusting the PiP window
The PiP window can be placed anywhere on the monitor in 3 possible sizes.
To reposition the PiP window:
1
Click inside the window.
2
Drag the frame to the position you want.
3
Click.
The PiP window moves to the new frame position.
•
If you decide you do not want to move the window, click again. The frame is not
selected anymore.
To change the size of the PiP window:
•
Move the cursor so that it is inside the window and press
decrease the window size.
or
•
Click inside the PiP window and then press
+/-
to increase or decrease the
window frame size. When you are finished, the PiP window changes size to fit
the frame.
+/-
to increase or
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Chapter 5
Making Measurements
Measurements and Calculations
Each Pro Package contains the measuring tools that you need for the calculations
contained in the package. You use these tools to measure different aspects of the
ultrasound image (and thus the underlying tissue); these measurements are used for
various calculations.
You can make measurements on archived images from the same type of ultrasound
system. The images must be in DICOM format, not .bmp. For information about the
format of stored images, see “HIPAA Compliance and Exporting Data” on page 57.
You cannot make measurements on video clips.
For calculation formulas and information about the accuracy of different types of
measurements, see “Clinical Measurements: Ranges and Accuracies” in the
& bk5000 User Guide
To view the list of measurements:
1
Freeze the image.
The
Measure and Mark
(click).
and the Technical Data (BZ2100).
bk3000
tab opens with some measurements for you to select
If the measurement you want is not visible, click
Advanced
is on) to find more options.
More Meas.
(visible when
Making a Measurement – General Procedure
The following sections contain detailed descriptions for using the various measuring
tools.
NOTE:
The image must be frozen to make measurements.
To make a measurement:
1
Click the name of the measurement.
A marker appears on the image.
2
Drag the marker to the position you want and click.
If the measurement requires 2 markers, another one appears.
3
Drag the second marker to the position you want and click.
4
Repeat this until you have positioned all the markers for the measurement.
NOTE:
The look of the markers themselves and of any lines that connect them depend
on what you are measuring.
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39
What the Measurements Indicate
•
Results
– The results of the measurement are displayed (continuously updated)
below the image. The result is color-coded to match a small square next to the
measurement on the image.
•
Depth
– While you are positioning the first marker for a distance measurement
in a B-mode or Color mode image, the displayed measurement is the depth of
the marker (distance from the marker to the transducer surface along the scan
line). When a second marker is positioned, the depth is replaced by the
appropriate measurement result.
Clearing a Measurement
There are 2 ways to clear a measurement and any current calculations that use the
measurement.
To clear a measurement
•
Point at the marker and long click it.
•
Point at the measurement result and long click it.
You can also clear all the measurements on the monitor at once.
To clear all measurements
•
Long press the
Measure
key.
B-Mode and Color Mode Measuring Tools
This section describes how to make the following types of measurements:
•
Distance
•
Perpendicular distances
•
Angle
•
Circle
•
Ellipse
•
Polygon
•
Freehand drawing of shapes
Distance Measuring Tool
Two markers can be positioned to measure a distance, for example, the length or
width of a structure. When the first marker is positioned, a second one appears for
you to position.
NOTE:
Pressing the
Measure
key starts a distance measurement.
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Figure 5-1. Positioning 2 markers on a B-mode or Color mode image.
Position first marker. First marker positioned; Second marker positioned.
NOTE:
The small numbers (1 and 2) shown in Fig 5-1 indicate the order in which the
markers appear. The numbers do not appear like this on the monitor.
To move a marker after they have all been positioned:
1
Click the marker.
2
Drag it to the new position.
3
Click.
Perpendicular Distances
Sometimes it is important for one distance to be measured perpendicular (at right
angles) to another distance. In this case, a small square appears at the intersection
point when the two measurement lines are perpendicular to each other.
Angle Measuring Tool
On a B-mode or Color mode image, you can measure 1 angle or 2 angles. The angle
measuring tool works slightly different from the other measuring tools. The numbers
in the following instructions refer to the numbers on the markers in Fig 5-2.
To measure an angle:
1
Click
Angle
.
A marker appears.
2
Position the marker and click.
A second marker appears, with a line connecting the two markers.
3
Position marker #2 to change the angle of the line. Click.
A third marker appears.
4
Position marker #3 and click.
A fourth marker appears, with a line connecting it to marker #3.
5
Position marker #4 to change the angle of the line. Click.
Angle
alpha
between the two lines is indicated on the image, and the size of the
angle appears as a measurement to the left of the image.
If you have chosen to measure 2 angles, additional markers appear for you to
measure another angle (
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beta
) with the first line.
41
Figure 5-2. Using the angle measuring tool to measure two angles.
Position first marker and
click.
Line appears.
Position marker 2 and click.
Marker 3 appears.
Position it and click.
Line appears.
Position marker 4 and click.
Angle alpha is measured.
Marker 5 appears.
Line appears. Position
marker 6 and click.
Angle beta is measured.
Position first marker. First marker positioned;
position second marker.
Second marker positioned.
If you just click and do not move any markers, the default angles are 60º.
To change the angle measurement after all the lines are positioned:
1
Click any marker and move it to change the length or orientation of one of the
lines.
NOTE:
If you click somewhere on the measuring tool that is not on a particular
marker, moving the trackball moves marker #1.
Circle Measuring Tool
On a B-mode or Color mode image, you can position 2 markers to measure a circle.
Position the markers in the usual way. As you move the second marker, the circle is
continuously redrawn on the monitor.
Figure5-3. Using the circle measuring tool.
After the markers have been positioned, you can move any of them by clicking and
dragging to a new location. Click again.
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To change the location or size of the circle:
All markers positioned. First marker selected. First marker repositioned.
All markers positioned. Entire circle selected. Entire circle repositioned.
Position first marker. First marker
positioned; position
second marker.
First and second
markers positioned;
position third
All markers
positioned.
1
Click one of the markers
2
Reposition the marker.
3
Repeat with the other marker, if necessary.
Figure 5-4. Repositioning one of the circle markers.
To move the entire circle without changing its size:
1
Click inside or on the circle.
A symbol (a plus sign with arrows) appears as shown in the center image of Fig
5-5. This symbol means you can move the circle.
2
Drag it.
3
Click again.
Figure 5-5. Moving an entire circle without changing its size.
Ellipse Measuring Tool
On a B-mode or Color mode image, you can use three markers to measure an ellipse.
Position the markers in the usual way.
Figure 5-6. Drawing an ellipse.
The first 2 markers determine a line that is used as the axis of rotation if you use the
ellipse to measure volume.
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NOTE:
Using the shorter distance as axis of
rotation results in an estimated
volume of the shape shown here.
Using the longer distance as axis of
rotation results in an estimated
volume of the shape shown here.
All markers positioned. Third marker selected. Third marker repositioned.
All markers positioned. First marker selected. First marker repositioned.
The axis of rotation critically affects the calculated volume. Consider the
basic shape of the structure of interest and make sure to place the first 2 markers so
that they define the correct axis of rotation. See Fig 5-7.
Figure 5-7. The effect of the rotation axis on volume determination.
The third marker is always equidistant from the first 2. Moving it makes the ellipse
broader or narrower. As you move the third marker, the ellipse is continuously
redrawn on the monitor.
After the markers have been positioned, you can move any of them by clicking and
dragging to a new location. Click again. See Fig 5-8.
NOTE:
Moving marker 1 or 2 in an ellipse will automatically move marker 3.
Figure 5-8. Repositioning markers in an ellipse you have drawn.
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To move the entire ellipse without changing its size or orientation:
Entire ellipse selected.
Entire ellipse repositioned.
All markers positioned.
First marker positioned;
position second marker.
Additional markers
positioned; shape is
automatically closed.
Position first marker.
1
Click inside or on the ellipse.
The move symbol – plus sign with arrows – appears.
2
Drag it.
3
Click again.
Not all of the ellipse has to lie within the ultrasound image.
Figure 5-9. Moving an ellipse.
Polygon Measuring Tool
On a B-mode or Color mode image, you can position several markers to define the
outline of a polygon. Position the markers in the usual way. After you position one
and click it, a new marker appears. A dotted line connecting it to the previously
positioned marker is continuously redrawn as you drag the new marker and click it
to position it.
To delete the marker you have just positioned:
•
Press
-
on the
+/-
key.
To undo the deletion:
•
Press +.
When you have positioned the final marker you want to use,
double-click
it to
indicate that it is the final marker in the polygon. A line is drawn from it to the first
marker. No new marker appears after you double-click the final one.
Figure 5-10. Drawing a polygon.
After the markers have been positioned, you can move any of them by clicking and
dragging to a new location. Click again.
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Figure 5-11. Repositioning one of the markers in a polygon.
Marker repositioned.All markers positioned. Marker selected.
Entire shape selected. Entire shape repositioned.All markers positioned.
To move the entire polygon without changing its size or orientation:
1
Click inside or on the polygon.
The move symbol – plus sign with arrows – appears (as illustrated in the middle
picture in Fig 5-12).
2
Drag it.
3
Click again.
You can move the shape to any location in the view.
Figure 5-12. Moving a polygon you have drawn.
WAR NI NG M- w1
If the sides of the polygon intersect (as in forming a curve like a figure eight, for example),
the area calculation is incorrect. In this case, the calculated area of the polygon is the area
of the bigger loop minus the area of the smaller loop.
Freehand Drawing on a B-Mode or Color Mode Image
On a B-mode or Color mode image, you can draw a closed shape freehand.
To draw freehand:
1
Click the measuring tool on the monitor:
A drawing cursor appears.
2
Drag it to where you want to start drawing. Click.
A second marker appears where you clicked.
3
Drag it to draw the shape you want.
To delete backward from the cursor, press
automatically moved back. To undo the deletion, press +.
- on the
+/-
key. The cursor is
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4
Starting point positioned;
draw trace.
Trace is drawn and shape is
automatically closed.
Position starting point.
Entire shape selected.
Entire shape repositioned.Shape drawn.
Position first marker. First marker positioned;
position second marker.
Second marker positioned;
measurement terminated.
1
1
2
1
2
When you have finished drawing, click the drawing cursor.
The shape is automatically closed by a straight line from the drawing marker to
the first marker (starting point).
Figure 5-13. Drawing a freehand shape.
You can move the shape to any location in the view.
Figure 5-14. Moving a shape you have drawn freehand.
Doppler Mode Measuring Tools
Making measurements on a Doppler mode image is different from measuring on a
B-mode or Color mode image because the Doppler mode image has
dimension. To avoid getting a negative result, successive markers must be positioned
to the right, not the left, of any already-positioned markers.
Positioning 2 Point Markers on a Doppler Mode Image
While you are positioning a marker, 2 cursor lines are displayed. One is horizontal
and one vertical, intersecting at the marker position.
Figure 5-15. Positioning 2 point markers on a Doppler mode image.
time
as a
After you position the markers, you can move one of them by clicking it and dragging
it. Click again when you have positioned it where you want it.
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Figure 5-16. Moving a marker you have placed on a Doppler mode image.
All markers positioned.
1
2
1
2
1
2
First marker selected. First marker re-positioned.
First line positioned;
position second line.
Second line positioned;
measurement terminated.
Position first line.
First line selected.
First line repositioned.All lines positioned.
You can position the markers anywhere in the Doppler mode image.
The appearance of the markers and whether they are connected by a dotted line
depends on what you are measuring.
Positioning 1 Point Marker on a Doppler Mode Image
If you are measuring something that needs only one marker, position the marker in
the same way as for 2 markers.
Positioning 2 Vertical Line Markers on a Doppler Mode Image
Two vertical line markers can be positioned on a Doppler mode image to measure
intervals.
To position the vertical markers:
1
Click the measuring tool.
A marker appears on the image.
2
Drag this to the position you want. Click.
Another marker appears.
3
Drag it to the correct position. Click.
Figure 5-17. Positioning vertical markers on a Doppler mode image.
After you position the markers, you can move one of them by clicking it and dragging
it. Click again when you have positioned it where you want it.
Figure 5-18. Moving a vertical line marker you have placed on a Doppler mode image.
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Drawing an Outline Curve on a Doppler Mode Image
Starting point positioned;
draw trace.
Trace is drawn.Position starting point.
On a Doppler mode image, you can draw an outline curve freehand.
To draw freehand:
1
Click the measuring tool on the monitor:
A drawing cursor appears.
2
Drag it to where you want to start drawing. Click.
A starting point marker appears where you clicked.
3
Drag the drawing cursor to draw the shape you want. (You can only drag to the
right; you cannot drag to the left.)
-
To delete backward from the cursor, press
on the
automatically moved back. To undo the deletion, press
4
When you have finished drawing, click the drawing cursor.
+/-
key. The cursor is
+
.
Figure 5-19. Drawing a freehand curve on a Doppler image.
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Chapter 6
Documentation
What are Documents?
This chapter describes ways to save, view and delete documents.
There are four different types of documents:
•
Images (2D and 3D)
•
Clips (2D and video)
•
3D data sets
•
Reports
In this chapter, the term “document” refers to all of these types of documents unless
a particular type is specified.
HIPAA Compliance
HIPAA (the American Health Insurance Portability and Accountability Act of 1996)
sets standards for handling patient data and medical records in a way that ensures the
privacy and security of all health-care related data. Each hospital or office must set
up procedures to make sure that all information that identifies an individual remains
confidential and safe. Always follow the procedures that have been established for
your workplace.
Information relating to HIPAA compliance can be found in the various parts of this
chapter:
•
“HIPAA Compliance and Exporting Data” on page 57
•
“Deleting Documents or Exams from the System” on page 64
•
“Password Protection of the Patient Archiving System” on page 66
Saving Documents – Capturing Images and Video Clips
You must have a patient ID entered in order to capture images and clips. Normally,
you should enter this before you start imaging. If you have forgotten to enter a patient
ID, and you have already made some measurements on an image, you can, however,
enter the patient ID and not lose the measurement.
To enter patient information for the current image (and measurement):
1
Open the
2
Enter patient information to start the exam.
3
Click
If the system is scanning, a clip capture will be started.
Patient
Capture
window (see page 62).
to capture the current 2D frozen image, with any measurements.
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Capturing 2D Images
On the
Documentation
tab, click
Capture
to save a 2D image or video clip to the
local patient archiving system. This captures an image if the image is frozen and
captures clips if the image is not frozen.
Video Clips – Capturing while Imaging
There are two ways to capture video clips when the image is not frozen.
You can use the
setting Forward Capture to be on or
also set the default clip length there.
Forward Capture ON
This is the default setting (click once to start recording and again to stop recording).
To record a video clip:
1
On the
2
Click
Forward Capture OFF – Capturing What Has Just Happened
Clip Storage and Cine Setup
Image
tab, click
Capture/Capture Clip
Capture/Capture Clip
window (see page 250) to specify (by
off
) how your system captures clips. You can
to start recording.
again to stop recording.
If Forward Capture is OFF, you can capture a video clip based on the cine loop of
what has just happened.
To capture a clip of what has just happened:
1
Make sure that
Enable forward capture
is not checked. See Fig C-6 on
page 251.
2
Click
Capture/Capture Clip.
The last 5 to 30 seconds of video data (from the cine loop) is captured and stored.
(You specify the length of the clip in the
Clip Storage and Cine Setup
see page 251.)
Capture while Not Imaging
It is possible to continue to capture a clip when you freeze the image, or even to start
to capture a clip when the image is frozen. This can be useful if you want to capture
the process of making a measurement, for example. If the system is
not
while not imaging, freezing the image pauses a clip capture that is in progress. You
can set up this functionality in the
Clip Storage and Cine Setup
window on
page 251.
Capturing 3D Data Sets
window;
set to capture
3D data sets are automatically saved to the patient archiving system.
Saving Reports
To save a report to the patient archiving system, click
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Save
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Local Patient Archiving System
Handle to enlarge
thumbnails
Handle to display thumbnails
on more than one row
Click to scroll through
thumbnails
The local patient archiving system contains information about patients and
examinations, including comments about patients or documents.
When you capture an image or save a document during an examination, it is saved
directly into the patient archiving system. The document browser is automatically
updated to show the saved documents from the current examination.
NOTE:
The patient archiving system can be password-protected. See “Password
Protection of the Patient Archiving System” on page 66.
Reviewing Documents
The Document Browser
Use the document browser at the top of the monitor to review and manage images
and other documents stored in the patient archiving system. You can select one or
more documents so that you can view, copy, or archive them.
You can also use the document browser to review images and other documents stored
or archived on external media, including network drives.
You cannot use the document browser to review images and other documents stored
on a Picture Archiving and Communication System (PACS).
The document browser contains thumbnails of the available documents. Each
thumbnail includes icons and numbers that give information about the document.
If the browser contains so many images that the thumbnails cannot fit on the monitor,
you can use arrows at the left and right end of the document browser to scroll through
the thumbnails.
To enlarge the thumbnails, drag the handle (little box) at the bottom of the document
browser. If the thumbnails cannot all fit in one row, a second handle appears for you
to drag so that the thumbnails are arranged in more than one row.
Figure 6-1. The handles and scroll arrows in the document browser.
To select or deselect a document:
•
Click the document thumbnail in the browser.
The frame around the document turns blue.
To select or deselect all documents in the browser:
•
On the
Documentation
tab, click
All
or
None
.
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To view a document:
•
Double-click the thumbnail. (You can also click
document selected.)
•
The frame around the document being viewed turns white.
View
, if there is only one
To see other documents in the patient archiving system, click
Archive
window opens. See “Exporting Data” on page 57.
View Archive
. The
To clear the viewed document from the imaging area:
•
Click
Close
.
The letters L and A on the thumbnail indicate whether the document is archived
locally or externally. If it is archived both locally and externally, both L and A are
shown. (You must enlarge the thumbnail to see the letters.)
Use the controls on the
Documentation
tab to manage the documents in the browser.
Some are listed in the following table.
Tool Function
Report
Exam List
Join
All
Open a report for the current examination.
Open the
Join selected video clips into one large clip. The selected clips are deleted
and replaced by the new large clip. The time label of the new clip is the latest
time of the selected clips.
Select all thumbnails in the document browser.
Archive
window.
None
View
Delete
Archive
Copy
Print
End Exam
Table 6-1. Documentation screen keys.
Deselects all thumbnails in the document browser.
Display the currently selected document (2D image, 2D video clip, 3D data
set, Pro Package report). If more than one document is selected, clicking
View
has no effect.
Delete the currently selected documents (see page 64).
Place documents in the staging area so that they can be burned on an
archive CD or archive them on a network drive or PACS.
Copy documents to CD/DVD or USB storage device, with or without patient
ID. For patient security, it is recommended to remove the patient ID. Reports
cannot be copied with the patient ID removed. Documents to be copied to a
CD are placed in a staging area (see “Staging Area” on page 58) so that they
can be collected to be burned on a copy CD/DVD. You can also copy to a
CD/DVD or a USB storage device in DICOM format.
Print selected 2D images or all 2D images from selected patients or
examinations. You can select the printer, including a DICOM printer, if your
system is set up as part of a DICOM network. You cannot print clips, 3D
images, or reports to a DICOM printer or to a video printer.
Closes current exam. Click
Enter Patient...
to start a new exam.
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Viewing and Editing Video Clips
Viewing and Editing a Video Clip on the System
When you view a video clip or cine image, there are special controls at the top of the
Documentation
also edit the clip.
NOTE:
Video clips are not displayed on an external monitor.
Video Clip Control Function
tab that you can use to play, pause, go forward, or go back. You can
Slider indicates current position in clip. When the clip is paused, you can
click the slider and move back and forth in the clip. See description of
cursors below.
Play, Pause. Only one of these is visible at a time.
Click to move the clip one frame backward or forward. Works when clip
is paused.
Left and right cursors. Click the icon to place the cursor next to the slider
at the current position in the clip. When the cursors are present, as
shown with the slider in the first row of this table, the clip will start from
the position of the left cursor and stop at the right cursor.
Cut. Click this to cut away (remove) the part of the clip that is between
the cursors. Both cursors must be positioned before you cut.
Crop. Click this to remove the part of the clip that is outside the cursor(s).
At least one cursor must be positioned before you crop.
Close Review
Table 6-2. Viewing and editing controls for video clips.
Closes the review in the image area. Changes made with Cut and Crop
are stored as a new clip that is added to the examination. After the
review is closed, you can delete the original clip if you want to keep only
the edited clip.
Viewing Exported Documents on the System
Documents that have been archived or exported1 to external storage media can be
viewed on an ultrasound system.
Documents that have been archived to a network drive can be accessed, just like
documents stored on the system, by selecting an examination in the
(See page 57.)
You can use the document browser to look through documents that you have
exported or archived to a CD/DVD, network drive or USB storage device.
Archive
window.
1. Note that if you want to view exported clips on the system, they must be exported in Lagarith
format.
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To view externally stored documents:
1
Insert a CD/DVD or insert a USB storage device into the USB connector on the
left side of the keyboard.
2
Click the
CD/USB
tab at the bottom of the
Archive
window.
A list of the folders on the external storage devices appears.
3
Click
Update
4
Click to select a folder.
in the
Archive
window.
The document browser is updated with the documents in the selected folder.
Viewing Exported Documents on an External Computer
Formats of Exported Documents
Copied Images
Images copied to a CD or USB storage device are stored in DICOM
or .bmp format. In .bmp format, they are labeled with a code that specifies the date
and time the image was captured. For example,
2D_20131022_135426_FV12345.bmp would be the label on an 2D image of patient
FV12345 that was captured on October 22, 2013 at 1:54:26 P.M. (13:54:26). The
label on a DICOM file is the same except that the file extension is .dcm.
Copied Video Clips
Archived Images and Video Clips
Video clips can be copied in .avi or DICOM format.
Archived images and video clips (including ones
archived on the system) are stored in DICOM format.
Viewing Images on a Computer
NOTE:
DICOM format requires a DICOM viewer on your computer.
Copied images have been exported in DICOM or bmp. format. You select the file you
want to view.
All
archived
images, whether on the system or on a CD, network drive or PACS
system, are stored in a DICOM format; you will not be able to read externally
archived documents on a computer unless you have a DICOM viewer.
Viewing Video Clips on a Computer
If the video clip has been exported in DICOM format, you can view it with a DICOM
viewer.
.
If the video clip is not saved in DICOM format, you can still view it on a PC, but you
must have a codec installed on the PC. You can set up the system to export the codec
to an external storage medium (see page 252). The codec is exported to a folder
called
Codec
.
To install the codec on your PC:
1
Use Windows® Explorer to view the contents of your external storage medium.
2
Open the folder called
3
Right-click the file called
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Codec
.
lagarith.inf
and click
Install
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Exporting Data
You can copy and archive documents so that they are stored outside the system.
The codec is installed.
NOTE:
Lagarith version 1.3.27.0 is required.
Copying
When you copy a document, only the document is copied, and not the
patient database. You can copy documents to a CD/DVD or a USB storage device.
Archiving
When you archive a document, the patient database is copied along with
the document. This ensures that you have a backup of the patient database as well as
ultrasound images in case anything happens to the system hard disk.
You can archive documents to a CD or a network drive. You can also archive them
to a Picture Archiving and Communications System (PACS).
HIPAA Compliance and Exporting Data
To preserve patient confidentiality when you copy patient data, select the option to
copy images and other documents to a CD or USB storage device
without the
identifying patient information: without patient ID.
If you archive to a CD/DVD or network drive, the archive is password-protected, but
you must still be aware that you are exporting confidential data from the system.
Copying to a CD/DVD or USB Storage Device
You can copy documents associated with a patient to a CD/DVD or USB storage
device. The system is set up to copy to one type of device or the other.
You can make more than one copy of a document.
See “Using CD/DVDs” on page 58 and “Using USB Storage Devices” on page 61.
To copy individual documents or all the documents associated with a specific
examination or patient:
1
Click to select the patient, the examination, or the individual documents you
want to copy.
2
Click
Copy.
3
Select the destination and whether you want to copy in DICOM format or not.
Copying the document
4
The documents are copied to the staging area for burning to a CD/DVD (see
without patient ID
is recommended for patient security.
“Staging Area” on page 58) or to the USB storage device.
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Archiving to a CD/DVD or Network Drive
To keep a permanent record of documents, you can archive them to a CD/DVD or a
network drive. See “Using CD/DVDs” on page 58 and “Using a Network Drive” on
page 61.
NOTE:
Archiving must be done to an empty CD/DVD. After you have archived
documents to a CD, you cannot use the same CD again for archiving.
You can archive a document to a CD/DVD or network drive only once. This means
that you cannot archive the same document to both a CD/DVD and a network drive.
The system keeps a record of where the document has been archived so that you can
always find an archived document.
To archive all documents for a patient or examination or individual documents:
1
Click to select the patient, the examination, or the individual documents you
want to archive.
2
Click
Archive
3
Select the archive location.
on the
Documentation
tab.
If you archive to a CD/DVD, you are asked for a volume name.
Using CD/DVDs
There are certain restrictions about copying and archiving to a CD/DVD:
•
You cannot burn both archived and non-archived documents to the same
CD/DVD.
•
You cannot archive to a CD/DVD that is not blank.
•
Problems can arise if one CD/DVD-burning program has been used to burn data
to a CD/DVD and you try to add new data using a different burning program.
The current system may use a different burning program from the one on older
systems.
NOTE:
a
CD/DVD
CD/DVD
s are vulnerable, and data may be corrupted when they are saved to
. After you save, check the
CD/DVD
to make sure that your data are saved
properly.
Remove the
CD/DVD
from the system before you turn it off because data can also be
corrupted when the system shuts down.
We recommend DVD-RW, DVD-R, CD-RW, and CD-R for use with BK equipment.
Staging Area
When you copy or archive to a CD/DVD, the selected documents are not copied
immediately to a CD/DVD. They are moved to a staging area. You can add more files
to the staging area before you burn them to a CD/DVD.
Set the size of the staging area to match the size of the CD/DVD. See “Setting the
CD/DVD Size” on page 250.
Files in the staging area do not disappear when you turn off the system. When you
turn on the system, you are reminded if there are files in the staging area.
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If you try to copy or archive documents and the total size, including what is already
in the staging area, is too big to fit on a CD/DVD, you are informed that you cannot
copy the documents to the staging area.
Burning a CD/DVD
To burn archives or copies to a CD/DVD:
1
Insert a CD/DVD into the DVD drive.
2
Click
Burn CD ...
The following window appears:
Figure 6-2. The Burn CD window.
3
If you are burning a copy, you must type a label name.
If you are burning an archive CD, you cannot specify the label name here.
4
Click
Burn
.
The progress bar tells you when the burning is finished. The keyboard and onscreen controls are disabled while the CD is being burned.
Reviewing and Deleting Documents in the Staging Area
You can also use the
staging area and to delete individual documents or clear all documents.
To review and edit the contents of the staging area:
•
Click
Show Details
The staging area browser appears in the
Burn CD
.
window (Fig 6-2) to examine the contents of the
Burn CD
window.
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Figure 6-3. The staging area browser in the Burn CD window.
The list on the left side contains a list (labeled with the time) of selections you have
put in the staging area.
If you click an item in the left-hand list, information about the individual documents
it contains appears in the right-hand list.
To view a document in the staging area:
•
Select it in the right-hand list and click
View
.
To delete individual documents from the staging area:
•
Select them (you can select more than one) and click
Delete
.
NOTE:
Be sure you have selected the correct documents to delete because they are
deleted from the staging area as soon as you click Delete. You are not prompted to
confirm that you want to delete them.
To clear all documents from the staging area:
•
Click
Clear Staging Area
NOTE:
When you clear the staging area, there is a risk of losing data if you have put
something there (for example by clicking
patient archiving system. You are asked to confirm the deletion.
NOTE:
Do not delete documents from the local patient archiving system until you
.
Copy
) and then deleted it from the local
have verified that they have been externally archived successfully.
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Using USB Storage Devices
If the system is set up to copy to a USB storage device, when you click
copying starts immediately. (Unlike for CD/DVDs, there is no staging area.) If more
than one USB storage device is connected, choose the local volume to copy to from
the list that appears.
NOTE:
Some USB storage devices are configured as two partitions (for example, D:
and E:).
NOTE:
Before you remove the storage device, click USB Eject. You will be notified
when it is safe to remove the storage device (no risk of losing data). If more than one
storage device is connected, both will be ejected.
Using a Network Drive
A network drive can be set up for archiving. See “Network Archiving” on page 256.
Network Password
To access the network drive from the system, you need to log on to the network using
your network username and password. There are 3 ways you can do this:
•
You are prompted for the network username and password each time you try to
access the network.
Copy,
the
•
If you use your network username and password as your system username and
password, you can leave the password field blank (for greater security) when
you set up network archiving. Then when you try to access the network drive
(when you are logged on to the system), the system logs you on with your
system username and password.
•
If you enter the network username and password when you set up network
archiving, the system remembers it for you and logs you in automatically. This
is the least secure method.
The Archive Window (Examination List and Patient Information)
You use the
documents in the patient archiving system. You can view documents, delete
documents, copy documents, archive documents, and send them to a PACS or a
DICOM printer.
The
Archive
system hard disk. See “Hard Disk Quota” on page 67 for more information about the
hard disk quota and how to create space on the hard disk.
To open the Archive window:
1
Press the
2
In the window that opens, click the
A list of examinations is displayed, including each examination for each patient.
Each row represents one examination of one patient.
Archive
window together with the document browser to manage all the
window also contains information about how much space is left on the
Patient
key or click the patient ID at the top of the monitor.
Archive
tab.
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61
Examination List, see below
Patient window.
Enter name and ID here. This
window contains additional
fields, depending on
examination type
Filter which
patients are
displayed, see
Tab le 6-3
Click to
- save patient details for all examinations or
- start new exam without clearing image or
- discontinue current exam
Click to edit current
patient
Free
space
on hard
disk
Figure 6-4. The Archive window with the Examination List and the Patient window.
Patient Information
To edit the current patient:
1
Click
Edit Patient
2
If you want the changes to apply to already archived examinations for that
patient, click
If you want to change the details only for the current exam, click
Current Exam
.
More
, then
Save patient details
.
.
After you do that, you can click to start a new exam without clearing the image. To
discontinue the current exam, click
More
.
If you forgot to enter new patient details before you started imaging, you can keep
the image while you add patient information.
To start a new exam without clearing the image:
•
Click
More
, then
Start new exam without clearing the image
.
Examination List
Continue
The
Examination List
contains patient IDs, names, and other information about
patients in the patient archive, including the date of the last examination.
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You can sort the listed patients according to the information in one of the columns by
clicking the column heading. For example, if you click the
Last Name
column, the
listed patients will be sorted alphabetically by last name.
To see documents from a particular examination, click the row containing the
examination. You can select more than one by holding down the
Ctrl
key. The
document browser is updated with the thumbnails of documents from the selected
examinations.
You can use the controls below the list to filter the information so that only certain
patients and examinations are displayed (see Table 6-3).
Select this Enter this in the
next field
Current patient
Patients examined today
All patients
Patients with exams
before...
Patients with exams after...
Patients with data
including...
Patient with patient ID
Patients with comments
including...
Not applicable
Not applicable
Not applicable
A date All patients who have any examination
A date All patients who have any examination
Smith
1975
the exact patient IDThe patient with a specific patient ID
“severe” (for
example)
Examinations displayed for these
patients
The current patient (the one whose ID is
displayed at the top of the monitor)
All patients that have been examined
today
All patients
before the date you enter
after the date you enter
Patients named Smith, Smiths,
Smithson, Whitesmith and those with
other names containing “Smith”
All patients born in 1975
All patients with a patient comment
that contains “severe”
Patients with document
comments including...
Not archived
All archived
Patients with
uncommitted documents
Patients with committed
documents
Patients with discontinued
examinations
Table 6-3. Ways to select the patients displayed in the Examination List.
bk3000 & bk5000 Advanced User Guide
“tumor” (for
example)
Not applicable
Not applicable
Not applicable
Not applicable
Not applicable
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All patients with a document comment
that contains “tumor”
All patients that have no archived
examinations
All patients with at least one archived
examination
All patients with uncommitted
documents.
All patients with committed
documents.
All patients with discontinued
examinations.
63
Hiding Part or All of the Examination List
You may not want all patients to be visible when the
Examination List
is displayed.
You can control which patients appear by setting a filter to be active by default. See
“Miscellaneous System Setup” on page 260.
Deleting Documents or Exams from the System
NOTE:
In rare circumstances, you may want to clear (delete) the entire patient
archive from the system. If you do, see “Miscellaneous System Setup” on page 260.
You can delete documents from the system if they have not been archived externally.
If they have been archived externally, you can delete the documents themselves from
the system, but the patient and the reference to the externally archived documents
remain.
NOTE:
You can delete a patient record from the system if the patient has no externally
archived documents.
To delete one or more documents (archived or non-archived) from the system:
1
2
You cannot delete a document that is in a queue to be sent to a DICOM device.
Click the images in the document browser to select them.
Click
Delete
on the
Documentation
tab and confirm that you want to delete the
documents.
The selected documents are deleted. If they were archived before they were
deleted, the examination record, with a reference to where the documents are
archived, remains on the system.
To delete all documents associated with an examination:
1
Click to select the examination. To select more than one row, press
Ctrl
you click.
2
Click
Delete
on the
Documentation
tab and confirm that you want to delete the
documents.
The documents associated with the selected examinations are deleted.
NOTE:
The examination record itself is never deleted (unless you delete the patient).
To delete an exam with no externally archived documents:
1
Click to select the row containing the exam. To select more than one row, press
Ctrl
while you click.
2
Click
Delete
on the
Documentation
tab.
You are asked to confirm that you want to delete the exam.
3
Click
Ye s
.
All local documents for the exam are deleted. The exam is deleted in the patient
archive if documents for the patient have not been externally archived (that is,
if they only appeared locally in the patient archiving system).
while
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Starting a New Examination from the Examination List
1. Click the arrows to scroll through month and year.
Right-click (use + side of
+/-
key to move back and
forth in 10-year steps.
2. Then click to select the day.
You can start a new examination from the
the window, the
If no patient is selected in the
Patient
window that opens contains patient data for that patient.
Archive
Archive
window. If a patient is selected in
window, the
Patient
window that opens is
empty.
You can also open the
Patient
) at the top of the monitor or pressing the
Patient
window by clicking the Patient name (or
Patient
key.
Enter
Entering Dates
There are 2 ways to enter dates:
•
Type the date in the date field. When you click in the field, the displayed date
changes to indicate the correct (numeric) format for entering the date. You must
type in numbers for the day, month, and year even if the date is going to be
displayed with the month spelled out.
If you type a date that is not allowed (for example, type 22 for the month), the
date is displayed in red until you enter a valid date.
•
Select the date from a calendar. Click the arrow to the right of the date field to
open the calendar.
Start Exam
After you have filled in the window, click
start the exam.
Pausing and Later Resuming an Examination
It is possible to pause an exam (for example, while you examine a different patient)
and then resume the exam with the first patient. Refer to the illustration of the
Archive
To pause an examination:
•
To resume a paused examination:
1
2
bk3000 & bk5000 Advanced User Guide
3
Start Exam
(or press
Freeze
window in Fig 6-4 on page 62 when reading the following procedures.
Open the
Open the
From the
Click
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Archive
Archive
window and click
window.
Examination List
Resume Exam
Pause Exam
, select an exam with the status
.
Pause
.
.
65
twice) to
NOTE:
Clicking
Do NOT select a paused exam and click
Start Exam
starts a NEW exam for the patient.
Start Exam
to try to resume it.
Password Protection of the Patient Archiving System
To help comply with HIPAA standards, the patient archive database on the system
can be password-protected with a user-specific ID (username) and password.
NOTE:
If you archive documents to a CD, the database copy on the CD is protected
with a different password. See “Viewing Images on a Computer” on page 56.
If the database on the system is password-protected, when you turn on the system, a
login window appears:
Figure 6-5. The login window.
Enter your system username and password and click OK. To change your password,
see “Password Setup” on page 255.
Not Logged In
If you click
patient archiving system or the 3D system. This means you cannot capture images or
clips or 3D data sets. You also cannot see patient information or documents in the
patient archiving system.
If you start the 3D system, the login window appears. If you log in, you are allowed
to use the 3D system (if you have a license for it).
The login window also appears if you try to enter a patient ID when you are not
logged in.
Cancel
in the window, you can use the system but you cannot use the
Emergency State
In an emergency, someone without a password may need to use the system and there
may not be time to type in a name and patient ID. In this case, when the login window
appears, click
In the emergency state, a default patient ID (“EmergencyID”) is used. You can
capture images and clips, but they will all have “EmergencyID” as the patient ID.
Emergency
. This puts the system in the emergency state.
NOTE:
If you have clicked Emergency in the login window, do not send pictures to a
PACS because they will be identified as EmergencyID and you will not be able to
identify pictures from different patients.
You can log in with your password at any time. When you do that, the emergency ID
disappears and you must enter a patient ID.
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Reports
Hard Disk Quota
The system hard disk does not have unlimited storage capacity.
The system checks the space on the hard disk each time you enter a new patient ID.
If the hard disk is getting full, you will be notified:
•
when there is less than 2GB available space on the hard disk.
•
when there is less than 1.5GB available on the hard disk.
•
when there is less than 1GB available on the hard disk. At this point, you will
not be allowed to save any more information to the hard disk.
To clear space on the hard disk, you must delete some documents. You can archive
them to a CD, DVD, or PACS (if you have DICOM installed) before you delete them
from the hard disk.
NOTE:
If you have archived the documents to a CD/DVD, wait to delete them from
the hard disk until you have successfully burned the archive CD/DVD. See “Using
CD/DVDs” on page 58. If you have archived them to a PACS, make sure that they
have been transferred successfully into the system before you delete them from the
system hard disk.
Reports are defined for each Pro Package. A report contains information about the
patient and the measurements you have made. You can add remarks, patient
comments and images to a report.
You can save a report to the patient archiving system and view, save or archive it in
the same way as you view or save other documents. See page 55. for more
information.
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Creating a Report
To create a report:
•
On the
Figure 6-6. An OB report.
The contents of the report will vary, depending on the Pro Package and the
measurements you have made.
Documentation
tab, click
Report
.
If the report has more than one page, click
Previous Page
and
Next Page
to navigate
through the pages.
Patient comments are included in a report. You can also add additional remarks.
To add a remark to a report:
•
Type in the
Remarks
area.
Adding Images to a Report
You can set up your system so that you can add all images to a report or only images
that you select to be included. The
described on page 260.
To add all images to a report:
1
In the
Miscellaneous System Setup
Report
2
Start the exam and save images, clips, etc.
3
On the
.
Documentation
All 2D images (but not clips, 3D images or reports) are added to the report.
To add selected images to a report:
1
In the
Miscellaneous System Setup
Report
2
Start the exam and save images, clips, etc.
3
Select some of the thumbnail images.
.
Miscellaneous System Setup
window, check
tab, click
Report
.
window, uncheck
window is
Include All Images in
Include All Images in
4
On the
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Documentation
tab, click
Report
.
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The selected 2D images (but not clips, 3D images or reports) are added to the
report.
Comments put in the
Patient
You can type in up to 4 lines of remarks on the first page of the report.
Editing a Report
You can edit a report before you save it.
To delete a measurement from a report:
1
Point at the measurement result in the
If the measurement is one that can be deleted, the measurement value is
highlighted in red and crossed out.
2
Click.
The measurement is removed from the report.
Printing a Report
To print a report:
•
Press the
The current page of the report is printed. If the report has more than one page,
click
them.
Print
key.
Next Page
or
Previous Page
window appear in the report.
Measurements
column.
to view other pages of the report and print
NOTE:
Reports can be saved as documents or captured as images but cannot be
printed directly from the thumbnails. In either case, open the thumbnail to print from
the monitor.
Saving a Report to the Local Patient Archiving System
To save the report to the local patient archiving system:
•
Click
Save
on the report.
Printing Documents or Images on the Monitor
You can print documents on a local printer or, if DICOM is installed on your system,
send them to be printed on a DICOM printer. You can also set up an office printer on
a network.
You cannot use an office printer directly with the USB connector on the system. The
only printers you can connect directly to the system are ones listed as approved in the
Product Data information. See also the Safety chapter in the
Guide
.
Caution
Print-c1
bk3000 & bk5000 User
The quality of a printed ultrasound image may vary, depending on the printer.
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Printing Thumbnail Images
To print thumbnail images (including archived ones) without opening them:
1
Click the thumbnails you want to print (to select them).
2
On the
3
Click the printer you want on the drop-down menu that appears.
The images are printed.
To open a thumbnail image and then print it:
1
Double-click the thumbnail image to open it.
2
On the
The default setting is for a black and white USB printer.
To set a different printer as default for the Print screen key:
1
Press
2
Click the little circle that appears on the top left corner of the
3
Scroll through the list that appears and click the printer you want.
4
Click the x in the top right corner of the list menu to close the menu and save
your changes.
Documentation
Measure and Mark
Fn+C
on the keyboard.
tab, click
tab, click
Print
.
Print
.
Print
screen key.
See Appendix E, “Configuring the bk3000 and bk5000” for more details.
Printing Images Displayed on the Monitor
To print an image displayed on the monitor:
•
Press the
Print
key on the keyboard.
You can customize how the Print key works.
To specify which printer the key will print to:
1
Make sure the image is not frozen.
2
Click
3
Advanced
Click the
Keys/Menus
, then
Customize
tab and in the
.
Assignments
pane in the window, find
Print.
4
Click
Print
and select a printer in the drop-down menu that appears.
A change in key assignment only affects the particular Pro Package that is selected
in the left pane on the tab.
Using a Transducer Button
You can set up a transducer button as a user-defined key for printing. See “UserDefined Keys” starting on page 245.
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Chapter 7 Imaging Modes
Imaging Modes
The bk3000 and bk5000 have various imaging modes.
Screen controls associated with an imaging mode are on the
The
Image
Image Tab” on page 18.
•
•
•
•
•
•
tab is divided into subtabs corresponding to the imaging modes. See “The
B-mode gives real-time 2D information about the anatomical structure of soft
tissues. Includes tissue harmonic imaging. B-mode controls are on the
subtab of the
Color mode (CFM, color flow mapping, color Doppler) ultrasound displays
color-coded, real-time information about direction and velocity of flow in the
tissues.
Power mode (power Doppler) ultrasound displays information about the number
of particles moving, rather than their velocity. Power mode controls are on the
Color
subtab of the
different types of Color mode.
Doppler mode (spectral Doppler mode) imaging displays information about the
spectrum of flow velocities as a function of time. Doppler mode controls are on
the
Doppler
Continuous wave Doppler (CW Doppler) imaging is used to detect very high
velocities in cardiac/echocardiography.
M-mode (motion mode) ultrasound is produced by slowly sweeping one line of
a B-mode image across the monitor. The M-mode image illustrates a time series
of images along this line.
Image
subtab of the
tab.
Image
tab because Color and Power modes are considered
Image
tab.
Image
workflow tabs.
General
NOTE: You cannot change imaging modes when the image is frozen.
Adjusting the Thermal Index Limit
Before you use the system, check that the TI settings are appropriate. The current TI
tissue type and limit are displayed on the right side of the monitor, under the image
area.
The absolute TI limit for each tissue type is set by the factory to conform to FDA
guidelines and international standards (AIUM/NEMA and IEC) (see the acoustic
output section in the
TI limit for some purposes. There are 2 types of settings you can vary:
•
Tissue type (TIS – soft tissue, TIC – cranial, TIB – bone)
•
TI limit (not exceeding the factory-set limits)
To select tissue type:
•
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Click the
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TI
bk3000 & bk5000 User Guide
type displayed and select
71
TIB, TIC
), but you may want to set a lower
, or
TIS
.
or
focal point – indicates the depth of the image
that is in best focus
range
upper boundary
lower boundary
•
Press the
+/-
key to toggle through the settings.
To adjust the TI limit:
•
Click the limit displayed after the TI type and select the value you want.
B-Mode
The current TI is displayed as
TIx:z.z<y.y
, where x is S, C, or B; y.y is the limit
you select; and z.z is the actual TI.
Focus
The ultrasound image is focused sharply within a selected zone, while the rest of the
image is not as well focused. The bk3000 and bk5000 can use either a single focal
zone or multiple (up to 3) focal zones (multiple focusing).
When more than one focal zone is active, ultrasound beams are focused at different
depths in the tissue. This improves the focus in several zones. However, using more
focal zones gives a lower frame rate. Thus using multiple focal zones when there is
much tissue movement causes the image to be blurred.
The
Focus
indicator to the left of the image shows the extent (range) of the focal
region as well as the point of best focus.
Figure 7-1. The Focus indicator.
The focal point triangle indicates the depth of the image that is in best focus – the
focal point. If there is more than one focal point the range automatically expands to
display the improved range of focusing. The actual number of focus zones is not
shown.
You can adjust both the position and range of the area in best focus.
To adjust focus position:
To move the focus up or down on the image, select the focus indicator and drag it
vertically to the desired position on the image.
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1
Select the
2
3
Drag the
Click.
Focus
B Focus Range
Focus
indicator by clicking on it or pressing the
indicator to the desired position.
Focus
key.
You adjust the focus range by clicking the
B Focus Range
screen key:
Select 1 for one focus zone and 2 for two focus zones, which will give you a larger
focus range than 1. Selecting
control the focus zones based on transducer type and selected
Default value for
B Focus Range
Auto
will let AMA (Automatic Mode Adjustment)
Res/Hz
is
Auto
.
Note: In some cases multiple focus zones are not supported. In this case, the B-focus
range screen key is inactive.
Tru -Fo cus
Selected transducers are equipped with Tru-Focus1. This focus enhancement gives
you full focus in the entire depth of the image. With Tru-Focus, it is not possible to
further adjust the focus position.
Gain
setting.
You can control the overall gain of an imaging mode by turning the mode key or by
clicking
Gain
on the
Image
tab.
TGC
The TGC (Time Gain Compensation) curve determines variable amplification
applied to echoes from different depths in the tissue. The TGC function compensates
for attenuation and scattering of the ultrasound beam in the tissue.
When you select a transducer, if all TGC sliders are in the center position, imaging
starts using a default TGC curve optimized for the transducer. (The default is either
the one set at the factory or one you have set up yourself.)
The
TGC sliders adjust the relative gain of the image at different tissue depths. Each
slider adjusts a specific part (1/8th) of the TGC curve; the topmost control adjusts the
top 1/8th of the image.
NOTE:
The sliders operate relative to their center position; when they are all
centered, the default TGC is used.
However, resetting the gain to the default setting may change the relationship
between the TGC sliders and the TGC curve.
1. bk5000 only.
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73
To adjust the TGC curve:
•
Move the
TGC
sliders to the right or left to adjust the TGC curve.
The shape of the TGC curve is temporarily displayed to the right of the image
as a curved vertical line. This indicates the modification that is applied to the
default TGC curve.
NOTE
: The TGC curve operates on the monitor image, not on the ultrasound echo.
Therefore, if you move or resize the image, you may have to readjust the TGC curve.
NOTE:
With 360° transducers, the top slider adjusts the part of the image that is most
central – that is, closest to the transducer.
Auto Gain
You can also choose to use Auto gain. With Auto gain, a selected preset defines the
brightness for this particular type of scan (also depending on the transducer). Auto
gain makes it possible to have the same brightness across different patients and body
parts.
To activate Auto gain:
• Long-press the Auto button,
or
• Click the AutoGain screen key on the right side of the screen and use +/- to
toggle between on and off.
Figure 7-2. Auto gain info on the right of the screen.
To adjust the brightness/strength of Auto gain, click
screen and use
NOTE:
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Chapter 7 November 2018
Adjustment here will result in a new default for all patients/body parts.
+/-
on the keyboard to increase or decrease the strength.
A-Gain Level
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to the right of the
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Settings
It is possible to select between 4 settings of Auto gain. Two of these are fully
automatic, two of them manual and require a click on the
want to optimize the image:
AutoGain settings:
1
Auto-Axial-
This setting equalizes the gain automatically and continuously
during scanning. The gain will be equalized in depth (i.e. axially) and the overall
gain will be adjusted.
2
Man-Axial -
you click the
In this setting, the gain will be adjusted to the current image when
Auto
button. The gain will be equalized in depth (i.e. axially) and
the overall gain will be adjusted.
3
Man-All -
you click the
In this setting, the gain will be adjusted to the current image when
Auto
button. The gain will be equalized in depth (i.e. axially) and
across the image, and the overall gain will be adjusted.
4
Auto-All -
This setting equalizes the gain automatically and continuously
during scanning. The gain will be equalized in depth (i.e. axially) and across the
image, and the overall gain will be adjusted.
Auto
button each time you
You select Auto gain setting by clicking the
Figure 7-3. The Auto Mode screen key with the different setting options.
NOTE:
Auto
You can configure the control button on the transducer to the same function as the
button.
Auto Mode
screen key:
Zoom
To zoom in or out on the area you are interested in, adjust the Zoom box and then
make the part of the image that is inside the box fill the monitor.
NOTE:
To use the Zoom box (zoom on different parts of the image):
•
•
To zoom in on a small part of the image, make the box smaller.
To move the Zoom box, select it and drag it.
To resize the box (zoom in or out), turn the H key or press
+/- when the box is
selected.
You can also resize the box by clicking one of the corners and then dragging the
corner or using the
+/-
key.
To return to the original image:
•
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Press H.
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75
Pressing
H?
the
Does this You can
key
First press Turns on the Zoom box and selects it.
You can move (drag) it or resize it.
Second press
Third press
Long press
Table 7-1. Overview of the Zoom key.
Makes the contents of the (selected)
Zoom box fill the entire monitor.
Returns image to the state it was in
before the first press.
Turns off the Zoom box.
Turn H key to change the size of the
Zoom box. Use trackball to move it
(drag) or resize it (
Press H to return to the previous
image.
+/-
Depth
With a full B-mode image, you adjust the depth to cut out parts below the part you
are interested in. The image always includes the transducer surface, so this key
changes the magnification of the image, stretching, or compressing it.
NOTE
:
To adjust the depth of the image without changing the magnification, you can
pan the image. When the image is panned, the top of the image does not necessarily
still correspond to the transducer surface.
Adjusting the depth of a zoomed image changes the magnification even though the
transducer surface is not necessarily visible at the top of the image.
key).
To adjust the depth:
•
On the Image tab, click
•
Place the cursor in the image field and press the
Depth +
or
Depth -
.
+/-
key on the keyboard.
or
•
Turn the H key when the Zoom function is turned off.
Gray Scales
Several gray scales can be used to display a B-mode image or an M-mode image.
Different gray scales may make various aspects of the image clearer.
To select the gray scale in B-mode:
1
Point at the upper right of the image area.
A gray scale bar appears.
2
Click the gray scale bar and select the gray scale you want.
To select the gray scale in M-mode:
•
Click the gray scale bar to the right of the M-mode image and select the gray
+/-
scale you want or point at the color bar and press
.
NOTE:
When you image in Color or Power mode, you cannot use the color bar to
change the B-mode gray scale because it is used to control the color mapping.
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Combination Modes
B-mode can be used in combination with other modes. (The terms
duplex
and
triplex
imaging refer to combinations of 2 or 3 modes.)
The available combinations are:
•
•
•
B+Color
B + M
B+Power
•
B+Doppler
•
B+Color+Doppler
•
B+Power+Doppler
To return to imaging with B-mode alone after you have been using it in combination
with other modes, press the
B-Mode
key.
To add another imaging mode:
•
Press the
for the imaging mode. (To add M-mode, you must click the
Color Mode, Power Mode
, or
Doppler Mode
key, or click the tab
M-Mode
tab on the
monitor).
To remove an imaging mode from the combination:
•
Press the key for the mode you want to remove. You can also click the imaging
mode tab when it is on top (This is the only way to turn off M-mode).
To return from a combined mode to B-mode only:
•
Press the
NOTE:
Pressing the
B-Mode
B-Mode
key.
key several times lets you toggle back and forth between
B-mode and any combined mode.
Tissue Harmonic Imaging (True Echo Harmonics – TEH)
Tissue harmonic imaging can reduce noise and improve the clarity of the ultrasound
image.
In normal B-mode imaging, the transducer uses essentially the same frequency range
for both transmitting and receiving. In harmonic imaging, the image is created by
receiving higher frequencies (harmonics) that are multiples of the transmitted
frequency (f). Tissue harmonic imaging in the bk3000 and bk5000 is based on the
2nd harmonic (2f) spectrum and pulse inversion.
Using TEH
TEH can be used only with transducers that support harmonic imaging.
Each preset that permits TEH has default settings for overall gain, TGC gain, contour
level, and contrast level for tissue harmonic imaging.
Restrictions
•
•
bk3000 & bk5000 Advanced User Guide
TEH is available for B-mode imaging only. If more than one imaging mode is
active, TEH will be disabled.
TEH is available only for certain transducers.
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Advantages
•
Better images with difficult-to-image patients.
•
Increased contrast resolution.
•
Reduced effect of grating lobes.
Limitations
•
Best in mid-range depth – the specific depth range for which harmonic imaging
works best depends on the transducer as well as other factors.
•
Reduced penetration.
•
Reduced lateral resolution.
•
Reduced frame rate.
To turn TEH on or off:
Make sure that you are imaging in B-mode (imaging is not frozen).
•
Press the
When you turn harmonic imaging off, B-mode imaging resumes with the frequency,
gain, dynamic range etc. that you were using previously.
Harmonic
key or click
Harmonic
on the
Image
tab.
Displayed Frequencies for Tissue Harmonic Imaging
When TEH is turned on, the letter H appears next to the displayed frequency, which
is the receiving frequency – double the transmitted frequency.
Contrast Imaging
In contrast imaging, a contrast agent consisting of microbubbles is injected into the
patient. When the ultrasound waves are reflected from the contrast agent, non-linear
responses are generated. The non-linear signals are received and analyzed to create
the contrast image.
Contrast imaging requires a software license from BK Medical and is available with
selected transducers only, see the bk3000 or bk5000 Product Data Sheet.
Contrast Agents
Contrast imaging is optimized for SonoVue® and DEFINITY® contrast agents. You
must follow the manufacturer’s guidelines for using contrast agents and pay attention
to any warnings, recommended precautions and contraindications.
Restrictions
Contrast imaging can be used only with:
•
B-mode imaging. If another imaging mode is active, contrast imaging is
disabled.
•
The transducers mentioned above.
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Simultaneous Split-Screen Imaging and Contrast Imaging
It can be an advantage to use simultaneous split-screen imaging (see “Simultaneous
Imaging” on page 30) with contrast so that you can see a contrast image that contains
no tissue information along with a B-mode image.
Figure 7-4. Contrast imaging with split screen.
To turn contrast imaging on:
•
Click on the
Contrast
tab.
It is also possible to configure a key to enable and disable contrast imaging. See
“Setting Up and Customizing Your System” on page 243.
C
When contrast imaging is turned on, the letter
appears next to the frequency at the
top of the monitor. Contrast imaging appears in simultaneous split mode, with
contrast imaging in screen A and B-mode in screen B.
To turn contrast imaging off:
Make sure that you are imaging.
•
Click on the
Contrast
tab.
or
•
Press [f].
NOTE:
When you turn contrast imaging off, the MI returns to its previous value.
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To use contrast imaging:
1
Make sure that you have a license for contrast imaging. See “Licenses” on
page 280.
2
Click
Setup
at the top of the monitor.
The
Pro Package Menu
3
Use B-mode imaging to locate the lesion and prepare for contrast imaging.
4
Click on the
Contrast
window appears (see “Pro Packages” on page 107.)
tab.
The contrast frequency is displayed at the top of the monitor, preceded by C.
5
Inject the contrast agent and start the timer. (See “Timer” below.)
6
Check the MI setting. When you turn on contrast imaging, the MI limit is
reduced to avoid bursting the bubbles in the contrast agent. You can turn
[
Doppler Gain
]
or click MI to make small changes to the setting in order to make
it suitable for the type of tissue and depth of the region of interest. (See
“Adjusting MI” on page 101.)
7
Click
Capture Clip
or
Capture Image
to save clips or images to the patient
archiving system so you can review them later.
8
If you want to inject more contrast agent, you can burst the remaining bubbles
first. (See “Bubble Burst” on page 81.)
Timer
You can start the timer to keep track of the elapsed time after you inject a contrast
agent. The time will be displayed on a saved or printed image.
NOTE:
The timer is always available - not just with contrast imaging.
To start the timer:
•
Click
Timer
The timer starts running and the elapsed time replaces the word “
The elapsed time is also displayed in the image area of the monitor. This time is
saved when you save or print the image. You can move the time to a new
location on the image by clicking and dragging it.
NOTE:
When you freeze the image, the time on the image is frozen. When you unfreeze
the image, the time on the image is updated to be correct.
To stop the timer:
•
Click
Timer
The time value in the image area disappears.
or press a user-defined key.
.
Timer
”.
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Bubble Burst
High
acoustic
output
during
Bubble Burst
X-Shine
When you use the
Bubble Burst
function, a stronger ultrasound pulse is emitted to
burst the remaining bubbles so that you can inject additional contrast agent to repeat
the examination.
To use Bubble Burst:
•
Click
Bubble Burst
Caution Exam-w6
When you turn on Bubble Burst, the acoustic output limits are increased to 1.9 (MI). This
change overrides any limits you have set. During Bubble Burst, the acoustic output will
exceed normal contrast imaging values and may approach the higher
(Bubble Burst) limits.
at the bottom of the monitor or press a user-defined key.
X-Shine uses an adjustment of ACI (Angular Compound Imaging) plus
improved focusing to help the user visualize the needle during interventional
procedures. A needle icon indicates where you will get the best visibility.
WAR NIN G
Before you attempt to use BK Medical equipment, you should be trained in
ultrasonography or be under the supervision of someone who is trained in
ultrasonography. You should also be thoroughly familiar with the safe operation of
your ultrasound system: read all the user documentation that accompanies it.
In addition, if your system interacts with other equipment directly or indirectly, you
need to be trained in making sure the interactions are both safe and secure.
No further training is required, but BK offers training in how to use the system.
Consult your BK representative for information.
WAR NIN G
The puncture line on the image is an indication of the expected needle path. To avoid
harming the patient, the needle tip echo should be monitored at all times so any deviation
from the desired path can be corrected.
GS-w1
P-w4
X-Shine is available as an option (license).
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Figure 7-5. Image showing the X-shine icon and inserted needle
In B-mode, you can access X-Shine on the keyboard (using the Steer
button) or add buttons on the screen using fn + C.
All controls function in the same way and cycle through 3 stages:
•
On
+
•
On
-
•
Off
On+ and On- switches sides on the image and Off returns you to default B-mode
image quality.
Activate X-Shine Imaging
Do as follows:
1
Ensure that
2
Cycle the
or use your selected screen key.
B-mode
On+, On-
is active.
and
Off
states on the
X-Shine
button on the keyboard
NOTE:
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Make sure that you adjust the icon
to match your needle insertion side.
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3
If needed, for example in steep needle angles, you can adjust the balance
between the needle strength echo and image quality. For this, use the
Strength
screen key. Increase the number to increase the needle shaft visibility.
Decrease the number to improve image quality over needle visualization.
Needle
Use the
trackball, or the
Needle Strength
Needle Strength
slider (Fig 7-6) if you prefer to adjust the balance using the
toggle (Fig 7-7) if you prefer to adjust the balance
by clicking the screen key.
Figure 7-6. Needle strength slider
Figure 7-7. Needle strength toggle screen key
Note that the
Needle Strength
screen key will only be active when X-Shine is on.
Adding Buttons to the Screen
You can add the X-Shine keys to the monitor controls on the screen. Select your
preferred X-Shine screen key and also add the Needle Strength slider or toggle to
improve needle visibility:
Figure 7-8. X-Shine slider.
Figure 7-9. X-Shine toggle.
To make a new screen key:
1
Press
Fn+C and click on available space (one with little circles).
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83
2
you cannot make a key here
you can make a key here
Select the key name (for example,
appears.
3
Press
Fn+C
to save your new configuration and leave Configuration Mode.
Color Mode and Power Mode
Color mode (CFM, color flow mapping, color Doppler) ultrasound displays colorcoded real-time information about direction and velocity of flow in the tissues.
Power mode displays color-coded information about the amount of flow but not the
direction.
Color Submodes
Labels clear all)
from the drop-down list that
On the
Color Image
tab, you can select the submode you want. The view must be
imaging when you do this.
Three submodes are available in Color mode imaging:
•
•
•
Velo ci ty
VFI
Tru-C o lor
(standard color mode)
(See “Vector Flow Imaging (VFI)” on page 89)
. Tru-Color is an alternative to normal color mode without the persist
1
1
function. It has less averaging and is therefore able to maintain a significantly
higher temporal resolution. In this way, you can more easily visualize the
hemodynamics, including differences between systole and diastole.
One submode is available in Power mode imaging:
•
Power (power Doppler).
Color Coding of Flow
In a Color mode image, the frequencies of the reflected ultrasound waves are
measured to show the velocity and direction of the blood flow. The result is displayed
in color on the monitor.
2
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1. bk3000 and bk5000.
2. bk5000 only.
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Flow Direction Default Color
Toward the transducer Red
Away from the transducer
Table 7-2. Default color coding in Color mode.
Blue
It is possible to invert this color-coding or select a different one.
Independent D-Mode/C-Mode Steering
Independent steering of PW Doppler and CFM is possible using the
screen key. To enable independent steering, click
Doppler
NOTE
tab and switch the setting to
:
This feature is only available for certain transducers and pro packages.
Off
.
Sync Steer
under the advanced
Sync Steer
Color Box
When Color mode or Power mode imaging is turned on, a color box is superimposed
on the B-mode image. The color box outlines the area of the tissue in which flow
information is available.
You can adjust the size and position of the color box to examine flow in various parts
of the B-mode image. The view must be imaging when you do this.
To resize the color box:
1
Point at the box or select it by clicking inside it or pressing the
2
Press
+/-
.
Color Box
or
•
Click a corner of the box and drag the corner.
To move the color box:
•
Click inside the box and drag the box.
Color Scales
Various color scales can be used to display a Color mode or Power mode image or a
Doppler spectrum.
To select the color scale:
•
Click the color bar to the right of the image and select the color scale you want.
NOTE:
When you image in Color or Power mode, you cannot use the color bar to
change the B-mode gray scale because it is used to control the color mapping.
key.
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Elastography
Elastography is a medical imaging mode using manual tissue compression or motion
from e.g. patient cardiac movement or respiration, in order to evaluate tissue
stiffness. Elastography requires a software license from BK Medical and is available
with selected transducers only, see the bk3000 or bk5000 Product Data Sheet.
Before using elastography, you should be adequately trained in ultrasonography.
Proper
Training
WAR NI NG
Before you attempt to use BK Medical equipment, you should be trained in
ultrasonography or be under the supervision of someone who is trained in
ultrasonography. You should also be thoroughly familiar with the safe operation of your
ultrasound system: read all the user documentation that accompanies it.
No further training is required, but BK Medical offers training in how to use the system.
Consult your BK Medical representative for information.
GS-w1
To activate elastography mode:
•
On the
Image
tab, click
Elasto.
Figure 7-10. Elastography imaging (default horizontal view).
1
Region of interest (ROI)
2
Color Map
3
Quality Indicator
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Color Box
When elastography mode imaging is turned on, a color box is superimposed on the
B-mode image. The color box outlines the area of the tissue in which information is
available.
You can adjust the size and position of the color box to examine various parts of the
B-mode image. The view must be imaging when you do this.
To resize the color box:
1
Point at the box or select it by clicking inside it or pressing the
2
Press
+/-
.
Color Box
or
•
Click a corner of the box and drag the corner.
To move the color box:
Click inside the box and drag the box.
Color Map
The color map represents the variants in levels of relative hardness/softness. The
default setting is red = hard, and blue = soft. If you click on the color map, you can
choose from a set of different color codes.
key.
Quality Indicator
The quality indicator displays the amount of pressure being placed on the transducer.
If the green indicator is at the top, transducer compression is at the optimum level
and the amount of noise is at an acceptable level for image acquisition.
Strain Ratio Measurement
Strain ratio measurements can be used to quantify the relative stiffness between the
region of interest (ROI) and the surrounding tissue. To perform a strain ratio
measurement:
1
Click the
2
Click inside the ROI and then move the trackball to create a measurement circle.
When the circle is the required diameter, click again to set the measurement
circle on the screen.
3
Repeat the measurement process outside the ROI.
The strain ratio appears under the image in a purple box. Note that the strain ratio is
reported as an inverse value.
Elastography
tab, click
Image
and then
Strain Ratio.
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Figure 7-11. A strain ratio measurement.
A measurement
circle inside the
ROI (elastography
A measurement
circle outside the
ROI (B-mode
The strain ratio
measurement
screen).
screen).
A diameter line
inside the
ROI (elastography
A diameter line
screen).
inside the
ROI (B-mode
screen).
The E- over Bdiameter
measurement
Diameter Comparison Measurement
The elastography diameter of an ROI can be compared to the B-mode diameter.
1
Click the
2
Click on the edge of the ROI in the elastography screen and move the trackball
to the opposite side of the ROI. Click again to place an E-diameter line.
3
Repeat the measurement process in the B-mode screen to place a B-diameter
line.
The E- over B-diameter measurement appears under the image in a purple box.
Elastography
tab, and then click
E/B Diameter.
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Figure 7-12. A diameter comparison measurement.
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Vector Flow Imaging (VFI)
Vector Flow Imaging is available as an option on the bk3000 and bk5000 ultrasound
systems.
Normally, color imaging shows only axial flows. Vector Flow Imaging is a
technology that uses ultrasound pulses in both axial and lateral directions. The
measured signals are therefore sensitive to both axial and transverse motion.
VFI requires a software license from BK Medical and is available with the following
transducers:
Transducer Recommended max. depth of using VFI
bk3000
6C2 60 mm 60 mm
14L3
10L2w
8L2
30 mm 35 mm
30 mm 40-50 mm
40 mm 50 mm
Recommended max. depth of using VFI
bk5000
VFI can be useful for the visualizing the following with high sensitivity:
•
Flow when the transducer is perpendicular to the vessel – flow visualization that
is independent of imaging angle.
•
Carotid and other vessels with high or complex flow.
NOTE:
Vector Flow Imaging is only available with certain transducers and certain
Pro Packages and presets.
Vector Flow Imaging can be used in the velocity range of 10 cm/s to 315 cm/s with
the corresponding PRF.
Using auto-correlation estimators, both the axial and transverse velocity components
are determined and used to make an estimate of 2D blood velocity that does not
depend on the image angle.
This method alleviates the problem of achieving a sufficient image angle and makes
it possible to visualize complex flow patterns.
The maximum velocity that can be observed depends on the PRF. Higher velocities
can be seen when the PRF is higher.
The direction and velocity of the flow are indicated on the image with color and also
by arrows.
Color Flow Indicators for VFI – The Color Map
The
Color Map
Map
bk3000 & bk5000 Advanced User Guide
Color Map
is the default color flow indicator for interpreting the color. The
outlines the maximum flow velocity by color. If you highlight the
you can choose between 3 different VFI color options.
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89
Color
Figure 7-13. Explanation of the Color Map for Vector Flow Imaging.
The colors indicate velocity flow.
Brighter colors indicate faster flow.
The number at the top of the Color
Map is the maximum velocity that
can be displayed by the color
coding in the VFI image. This can
be changed by changing the PRF.
3 VFI color options. First 2
options activate the Color
Square.
This color indicates purely
axial flow (24 cm/s).
This color indicates flow down
and to the left.
The speed is about 23 cm/s
(axial and transverse velocity
components both 16 cm/s).
This color indicates purely
transverse flow (24 cm/s).
Saturation/Brightness = Speed
Colors located nearer the top of the
Color Map
(less saturated colors) indicate faster
flow.
Color Flow Indicators for VFI – The Color Square
The
Color Square
choose this color indicator, flow direction and velocity are mapped by color. You can
move the
Color Square
interfere with what you are trying to observe.
Figure 7-14. Explanation of the Color Square for Vector Flow Imaging. The values are only for
illustrative purposes, as the color information is intended to be qualitative rather
than quantitative.
is an alternative to the
Color Map
for interpreting color. If you
around on the monitor (like a bodymark) so that it does not
Saturation/Brightness = Speed
The center of the square is black. Black indicates zero flow.
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Colors located farther from the center (less saturated colors) indicate faster flow.
Color (Hue) = Direction
The color (hue) indicates the flow direction. For example, yellow indicates flow up
and to the right.
Using VFI
VFI is activated by selecting an appropriate VFI preset. VFI presets are only
available with the 14L3 and 10L2w transducers for bk3000 and transducers 6C2,
14L3, 10L2w and 8L2 transducers. You can choose from the
the
Vein VF I
preset.
Alternatively, you can turn on VFI by:
1
Clicking Advanced on the Image tab.
2
Clicking the Color tab.
3
Clicking Submode and then VFI.
Steering of the color box is not possible when you use VFI
Carotid VFI
preset or
Figure 7-15. Selecting VFI submode.
Arrow Flow Indicators for VFI
Direction and relative velocity are also indicated by arrows superimposed on the
flow part of the image. Longer arrows indicate higher velocity.
WAR NI NG
Before you turn on VFI, check the B-mode image to make sure there are no artifacts visible
in the blood vessel. If there are strong artifacts in the B-mode image, the arrows in VFI may
be pulled to point in a more axial direction (toward or away from the transducer),
especially in low flow situations with correspondingly low PRF. These artifacts will not
affect the color mode (CFM) image, so it is important to check in B-mode.
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Arrow Size (VFI)
Use
Arrow Size (VFI)
arrows in VFI mode. You can choose 3 different size settings (the default setting is
Large):
Figure 7-16. Small arrow size.
to adjust the space between the arrows and the size of the
Figure 7-17. Medium arrow size.
Figure 7-18. Large arrow size.
Streamlined VFI Workflow
VFI can be utilized to ease workload when determining peak systolic velocity or
calculating volume flow rate.
In
B+VFI+D
•
Doppler gate placement
•
Angle correction
•
Assisted Doppler steering
mode, VFI can assist the user with:
•
Inverting the Doppler spectrum (when needed)
•
Selecting the appropriate Scale/PRF (Pulse Repetition Frequency)
•
Adaptively adjusting Doppler sample volume size (PW gate)
•
Assisted Volume Flow Measurement
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Assisted Doppler Gate Placement
Assisted Doppler gate placement is a method for selecting the optimal Doppler gate
position when measuring the peak systolic velocity in arteries. The method uses VFI
data to analyze where to place the Doppler gate at the highest velocity within the
color box and the ROI (region of interest). The VFI data is also used to display and
update flow direction, velocity, and Doppler in real-time.
To activate the assisted Doppler gate placement:
•
Press
Doppler Mode
or
•
Press
Doppler Gate
if you are in B+VFI mode.
if you are in Triplex+VFI mode.
Arrow
aliasing
WAR NI NG
Check to make sure the VFI arrows are not aliasing before you activate the assisted
Doppler gate placement. Otherwise, the Doppler gate will not be positioned correctly.
VFI-w2
Angle Correction
The angle of the flow at the position of the Doppler gate (selected either manually by
the user or by the VFI data) is estimated and displayed in real-time. The estimated
direction of the flow is indicated visually by the line passing through the Doppler
gate (See Fig 7-20).
Assisted Doppler Steering
From the indication of the flow, the appropriate Doppler steering is selected using
VFI data. Gate steering is updated dynamically. The steering angle corresponding to
the angle of the flow is displayed in real-time, making it easier to monitor when the
desired Doppler angle of 60° is achieved.
Inverting the Doppler Spectrum
Automatic inversion of the Doppler spectrum is activated when the gate steering
changes from right to left.
Selecting the Appropriate Scale/PRF
If the manually specified Scale/PRF is too low or too high, it can be adjusted using
VFI data.
To activate assisted Scale/PRF adjustment:
•
bk3000 & bk5000 Advanced User Guide
Click
Auto Scale ON/OFF:
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When assisted Scale/PRF adjustment is activated, enabling Doppler mode or
pressing
Doppler Gate
will change the Scale/PRF based on the VFI data.
Pressing the
•
If the initial Scale/PRF is far from correct, or the Doppler baseline is not
adjusted correctly, it may be necessary to press
•
If the Doppler Gate adjustment is not satisfactory, you can revert to adjusting
Scale/PRF and the Doppler baseline using
Doppler Gate
key will also adjust the Doppler baseline.
Doppler Gate
Auto
. This adjusts Scale/PRF (and
more than once.
Doppler baseline) using only the Doppler spectrum. However, this can cause the
VFI signal to alias. Therefore, adjusting Scale/PRF using
Auto
should only be
done when the Doppler gate is at the maximum velocity position.
Assisted Volume Flow Rate Estimation
Volume flow rate is an indication of the amount of blood that passes through a vessel
over a specific time span, typically [ml/min]. Assisted volume flow rate estimation
uses VFI data and Pulsed Wave Doppler (PWD) to calculate the volume flow rate in
a vessel. Assisted volume flow rate estimation uses VFI data to outline the vessel and
extend the Doppler gate to cover the entire vessel. Visual diameter markers are
inserted for the user to inspect. If preferable, you can manually adjust the visual
diameter markers.
To activate assisted volume flow rate estimation:
•
Click
VF (real-time)
Diameter
markers
Doppler gate
large
enough
Doppler gate
only over
one vessel
The result of the assisted volume flow rate calculation is displayed in a real-time
measurement value called VF.
WAR NI NG
Check to make sure that the diameter markers correspond to the inner vessel wall and that
the connecting line between the markers is perpendicular to the direction of the vessel.
Otherwise, the real-time volume flow measurement may not be precise.
WAR NI NG
Check to make sure that the Doppler gate covers the entire vessel. Otherwise, the realtime
volume flow measurement may not be precise.
WAR NI NG
Check to make sure that the Doppler gate only covers one vessel. Otherwise, the real-time
volume flow measurement may not be precise.
VFI-w3
VFI-w4
VFI-w5
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Asymmetric Doppler Gate Cross
WAR NI NG
Doppler
spectrum
aliasing
Check to make sure that the Doppler spectrum does not alias. Otherwise, the real-time
volume flow measurement may not be precise.
The asymmetric Doppler gate cross places the POI (point of interest) at the highest
velocity, and adjusts the Doppler gate to the size of the vessel. You can manually
move the POI to another point in the vessel, and the asymmetric Doppler gate cross
will still automatically adjust to the size of the vessel.
Outline of VFI Workflow
The screen capture in Fig 7-19 outlines the main features of the VFI workflow:
1
Asymmetric Doppler gate
2
POI
VFI-w6
Figure 7-19. Outline of VFI workflow with 14L3 transducer.
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Doppler Mode – Spectral Doppler
Doppler line
Doppler gate
(sample volume)
angle correction line
false sample volume
Doppler mode (spectral Doppler mode) imaging displays information about the
spectrum of flow velocities as a function of time. It is sometimes called FFT (Fast
Fourier Transform) because the information is presented as a frequency spectrum
indicating velocity components.
Turning Doppler Mode On or Off
When you turn Doppler mode on, B-mode must be imaging.
To turn on Doppler mode:
•
Press the
The Doppler indicator, including both the Doppler line and the Doppler gate,
appears superimposed on the B-mode image and the Doppler spectrum appears.
Doppler Mode
key.
To position the Doppler gate on a larger B-mode image, press the
and position the Doppler gate before you press the
Figure 7-20. The Doppler indicator (line and gate) superimposed on a B-mode image.
Doppler Mode
Doppler Gate
key.
Fig 7-21 shows information available in Doppler indicators.
key
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Chapter 7 November 2018
Figure 7-21. Doppler indicators (three examples).
Fig 7-21 (a)
The dotted line represents the Doppler line. The lines at right angles to
that show the Doppler gate.
Fig 7-21 (b)
A diagonal line (relative to the Doppler line) indicates a sample volume
with angle correction.
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Fig 7-21 (c)
The horizontal dotted lines show the false sample volume in HPRF (see
page 97).
To turn off Doppler mode:
•
Press the
Doppler Mode
key or the
Adjusting the Doppler Mode Image
Doppler Indicator
When Doppler mode imaging is turned on, the Doppler indicator is superimposed on
the B-mode image.
You can adjust the position and size of the Doppler gate to get information from
sample volumes in various parts of the B-mode image. The image must not be frozen
when you do this.
To move the Doppler gate:
•
Click the Doppler indicator or press the
The sample volume line moves along with the gate.
To resize the Doppler gate:
B-Mode
Doppler Gate
key.
key and drag the gate.
•
Point at the Doppler indicator, (or click it, or press the
then press
+/-
.
Doppler Gate
Independent D-Mode/C-Mode Steering
Independent steering of PW Doppler and CFM is possible using the
screen key. To enable independent steering, click
Doppler
NOTE
tab and switch the setting to
:
This feature is only available for certain transducers and pro packages.
Off
.
Sync Steer
under the advanced
Sync Steer
Doppler Trace (Automatic Curve Tracing)
The system can automatically calculate and display a curve that traces the mean or
peak values of the Doppler spectrum. See “Doppler Measurements” on page 109 for
a description of the curves. You can also choose to have both the peak and mean
curves displayed.
To change which curve is displayed or to turn off the display:
•
Click
Trace
on the
To measure higher flow speeds (high range setting) in a sample volume placed deep
in the tissue, HPRF (high PRF) is automatically used. When HPRF is active, the
Doppler line shows the actual sample volume, and false sample volumes (shown
dotted). See Fig 7-21 on page 96.
Doppler
tab and select
Off, Peak, Mean+Peak
key) and
, or
Mean
.
The false sample volumes should always be placed outside a vessel.
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Sweep Speed
M-Mode
You can adjust the sweep speed to change the number of cycles of the spectrum
displayed on the full time axis. The available values range from 2 (slowest) to 8
(fastest).
To select the sweep speed:
•
Click
Sweep
on the advanced
Image
tab and select the required value.
The time axis is updated.
There is no M-mode key on the keyboard.
To turn M-mode on or off:
•
Click the
M-mode
subtab of the
Image
tab.
NOTE:
M-mode is only available for certain Pro Packages. The M-mode tab is visible
only when M-mode is available.
M-mode (motion mode) ultrasound is produced by slowly sweeping one line of a
B-mode image across the monitor. The M-mode image illustrates a time series of
images along this line.
M-mode can only be used in combination with B-mode. Selecting any other mode
will turn off M-mode.
You can return to imaging with B-mode alone by pressing the
B-Mode
M-mode uses the same imaging frequency and focus settings as B-mode.
NOTE:
Only a single focal zone is possible in M-mode.
Zooming and panning do not work directly in the M-mode image. When you make
changes in the B-mode image, they are applied to the M-mode image.
The M-Mode Image
When M-mode is selected, the monitor is divided into two windows (see Fig 7-22).
You can adjust how the two windows are displayed.
key.
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Figure 7-22. M-mode image.
B-mode
image
M-mode line
M-mode
image
appears
here
M-Mode Line
The M-mode line (see Fig 7-22) shows the path of the M-mode image in the B-mode
window. You can adjust the path of the image by moving the M-mode line (click it
and drag).
M-Mode Image Ruler
The M-mode image ruler scales the ruler range of the B-mode image to the M-mode
image. Any given value will represent the same position on both the M-mode and
B-mode images.
It is not possible to change the ruler.
Saving a Preset
When you have changed the setup, you can save it as a new preset.
To save a preset:
1
bk3000 & bk5000 Advanced User Guide
On the
The
Image
Save Preset
(16-01487-01) Imaging Modes
tab, click
window appears.
Advanced
99
. Then click
Save.
Figure 7-23. The Save Preset window.
2
Enter a name for the preset and select the options you want, for example,
whether you want the setup to be the default for the transducer with the current
Pro Package. (Puncture guide or brachy matrix settings will be saved as part of
the setup.)
3
Click
Save
.
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